Loading...
Please wait, while we are loading the content...
Similar Documents
Optimal primary management of bulky stage IIIC ovarian, fallopian tube and peritoneal carcinoma: Are the only options complete gross resection at primary debulking surgery or neoadjuvant chemotherapy?
| Content Provider | Scilit |
|---|---|
| Author | O'Cearbhaill, Roisin Sioulas, Vasileios D. Schiavone, Maria B. Kadouri, David Zivanovic, Oliver Roche, Kara Long Abu-Rustum, Nadeem R. Levine, Douglas A. Sonoda, Yukio Gardner, Ginger J. Leitao, Mario M. Chi, Dennis S. |
| Copyright Year | 2017 |
| Description | Journal: Gynecologic Oncology Objective To explore the impact of primary debulking surgery (PDS) to minimal but gross residual disease (RD) in women with bulky stage IIIC ovarian, fallopian tube, or primary peritoneal cancer. Methods We retrospectively reviewed all patients with the aforementioned diagnosis who underwent PDS at our institution from 01/2001–12/2010. Those with disease of non-epithelial histology or borderline tumors were excluded. Clinicopathologic data were abstracted, and appropriate statistical tests were used. Results We identified 496 eligible patients. Median age was 62years; 91% had disease of serous histology. Patients were grouped by RD status: no gross RD, 184 (37%); RD of 1–5mm, 127 (26%); RD of 6–10mm, 54 (11%); and RD >10mm, 131 (26%). With a median follow-up of 53months, the median progression-free survivals (PFS) were: 26.7, 20.7, 16.2, and 13.6months, respectively (p<0.001). The median overall survivals (OS) were 83.4, 54.5, 43.8, and 38.9months, respectively (p<0.001). Among patients with RD following PDS, those with RD of 1–10mm had improved PFS (p10mm. Patients with RD 1–10mm who received intravenous/intraperitoneal (IV/IP) chemotherapy were younger and had prolonged OS compared with those solely exposed to IV chemotherapy (p<0.001 and p=0.002, respectively). Conclusions PDS to no gross RD was associated with the longest PFS and OS. However, cytoreduction to 1–10mm of RD was also associated with better survival outcomes compared with cytoreduction to >10mm of RD. We conclude that PDS remains an appropriate option for patients with a high likelihood of achieving RD 1–10mm, especially for younger patients who can receive IV/IP chemotherapy after PDS. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386177/pdf http://www.gynecologiconcology-online.net/article/S0090825817301440/pdf |
| Ending Page | 20 |
| Page Count | 6 |
| Starting Page | 15 |
| ISSN | 00908258 |
| e-ISSN | 10956859 |
| DOI | 10.1016/j.ygyno.2017.02.023 |
| Journal | Gynecologic Oncology |
| Issue Number | 1 |
| Volume Number | 145 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2017-02-19 |
| Access Restriction | Open |
| Subject Keyword | Journal: Gynecologic Oncology Ovarian Cancer Primary Debulking Surgery Neoadjuvant Chemotherapy Optimal Cytoreduction Residual Disease |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
