Women with advanced ovarian cancer have fewer side effects and tend to have a better quality of life if given chemotherapy before surgery, according to a Cancer Research UK study* published today (Wednesday) in The Lancet.
“The trial showed that shrinking the tumour before surgery reduced side effects and hospital stay – meaning improved quality of life, without compromising survival, which is better for patients.” – Professor Sean Kehoe, University of Birmingham.
The CHORUS trial, conducted at the Medical Research Council Clinical Trials Unit at University College London, challenged the international standard for treating advanced ovarian cancer.
550 women with the disease took part in the trial, with 276 given the standard treatment of surgery followed by six cycles of chemotherapy, and 274 had surgery after three cycles of chemotherapy.
The Cancer Research UK funded trial found that post-surgery complications and death within 28 days of surgery was most common among women given surgery first. Women who received delayed surgery suffered fewer symptoms, a reduction in overall side effects and had a lower death rate**.
Delaying surgery also reduced the amount of time the patient spent in the hospital after surgery*** – a benefit to both the patient and NHS resources.
The CHORUS trial is the largest surgical trial of its kind in the UK and second largest in the world. It aimed to see if this new treatment strategy was a good alternative to the traditional approach.
Professor Sean Kehoe, study author and professor of gynaecological cancer at the University of Birmingham, said: “The trial showed that shrinking the tumour before surgery reduced side effects and hospital stay – meaning improved quality of life, without compromising survival, which is better for patients. We are so thankful to the women who took part in the trial and their families, as we couldn’t have done this important research without them. Because of their generosity we can improve the lives of others.”
Ovarian cancer is the most common cause of death amongst gynaecological cancers and the fifth most common cause of cancer death among women in the UK****.
Professor Peter Johnson, chief clinician at Cancer Research UK, said: “This is a great example of how research can help us to plan the best care for people with cancer. Whether to have chemotherapy before major surgery for ovarian cancer has always been a dilemma for women and their surgeons. Thanks to this study we can say that having chemotherapy first makes the surgery safer, the stay in hospital shorter and women’s quality of life better. These are important results that will make a big difference to many women in the future.”
For media enquiries contact the Cancer Research UK press office on 020 3469 8300 or, out of hours, on 07050 264 059.
* Kehoe et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. The Lancet. DOI: 10.1016/S0140-6736
**80 per cent of women in the primary surgery discharged within 14 days after surgery against 93 per cent after delayed surgery
***231 women died in the primary surgery group with an average survival of 22.6 months. 220 died in the primary chemotherapy group with an average survival of 24.1 months.