A retrospective study spanning ten years at Nottingham University Hospitals Cancer Centre and published in Obstetrics and Gynecology International, examined outcomes for two common treatment strategies in patients with advanced-stage endometrial cancer (FIGO Stage III–IV): primary cytoreductive surgery (PCS) followed by adjuvant therapy, and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS). The study reviewed the records of 65 patients treated between 2013 and 2023, with 57 undergoing PCS and eight receiving NACT-IDS.
Patients in the NACT-IDS group tended to have more extensive disease, with 75% diagnosed at Stage IV compared to just 5.3% in the PCS group—a statistically significant difference. Despite this, PCS patients had longer median progression-free survival (35.5 months vs. 18.5 months) and overall survival (41.0 months vs. 22.0 months). However, the differences were not statistically significant, likely due to the small sample size of NACT-IDS.
The NACT-IDS group had longer operative times (averaging nearly 240 minutes compared to 165.5 minutes in the PCS group) and a higher rate of open surgical procedures—100% versus 49.1% for PCS. This was also reflected in postoperative recovery, with median hospital stays significantly longer in the NACT-IDS group (8 days compared to 3 days). Radiotherapy was used more frequently in the PCS group (59.6% vs. 25%), and while recurrence rates were slightly higher in the NACT-IDS cohort (37.5% vs. 33.3%), the difference was not statistically meaningful.