Single-Institution Retrospective Analysis of Ovarian Cancer Outcomes from the Middle Eastern Republic of Georgia

Purpose Ovarian cancer (OC) diagnosis and management is challenging in any country; however, in Middle Eastern Republic of Georgia (MEROG), limited resources pose additional challenges. Our surgical goal mirrors international goals of cytoreduction to no gross residual disease (R0). We used international SCORPION trial results as a benchmark for historical contextual comparison. Methods Single institutional retrospective data were collected at Medical Center Innova (MCI), Tbilisi, Georgia. All consecutive stages I-IV OC patients (n = 107) received care by single medical oncologist and single surgical group during 2016-2020. Two treatment strategies were employed: Group A [n = 29, neoadjuvant chemotherapy (NACT)] received neoadjuvant three cycles of chemotherapy with paclitaxel 175 mg/m(2) and carboplatin AUC 5-6 IV day 1, followed by interval cytoreductive surgery and three additional cycles of chemotherapy. Group B cases [n = 78, primary debulking surgery (PDS)] received upfront surgery and six cycles of adjuvant chemotherapy same scheme. Results Of the 107 OC cases treated, 95 (88%) patients were diagnosed at late stage. Mean age in our cohort was similar (57 year; range 22-80) as compared to SCORPION cohort. Most cases (92%) were high-grade serous OC. Twenty-nine cases (27%) received NACT, and R0 resection rate in this group was 86%. Seventy-eight women (72%) had upfront surgery with an R0 rate of 82%. Conclusions The R0 rates in our MEROG are comparable to/better than SCORPION trail results for the treatment strategies [upfront surgery group (82 vs.47%) and neoadjuvant group (86 vs.77%)]. The outcomes of patients with advanced-stage OC treated in low-resource/middle-income country (Georgia) are comparable to the broader European experience.