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Continuous improvement in primary Debulking surgery for advanced ovarian cancer: Do increased complete gross resection rates independently lead to increased progression-free and overall survival?
| Content Provider | Scilit |
|---|---|
| Author | Tseng, Jill H. Cowan, Renee A. Zhou, Qin Iasonos, Alexia Byrne, Maureen Polcino, Tracy Polen-De, Clarissa Gardner, Ginger J. Sonoda, Yukio Zivanovic, Oliver Abu-Rustum, Nadeem R. Roche, Kara Long Chi, Dennis S. |
| Copyright Year | 2018 |
| Description | Journal: Gynecologic Oncology To assess complete gross resection (CGR) rates and survival outcomes in patients with advanced ovarian cancer who underwent primary debulking surgery (PDS) during a 13-year period in which specific changes to surgical paradigm were implemented. We identified all patients with stage IIIB-IV high-grade ovarian carcinoma who underwent PDS at our institution, with the intent of maximal cytoreduction, from 1/2001–12/2013. Patients were categorized by year of PDS based on the implementation of surgical changes to our approach to ovarian cancer debulking (Group 1, 2001–2005; Group 2, 2006–2009; Group 3, 2010–2013). Among 978 patients, 78% had stage IIIC disease and 89% had disease of serous histology. Carcinomatosis was found in 81%, and 60% had bulky upper abdominal disease (UAD). Compared to Group 1, those who underwent PDS during the latter 2 time periods had higher ASA scores (p < 0.001), higher-stage disease (p < 0.001), and more often had carcinomatosis (p = 0.015) and bulky UAD (p = 0.009). CGR rates for Groups 1–3 increased from 29% to 40% to 55%, respectively (p < 0.001). Five-year progression-free survival (PFS) rates increased over time (15%, 16%, and 20%, respectively; p = 0.199), as did 5-year overall survival (OS) rates (40%, 44%, and 56%, respectively; p < 0.001). On multivariable analysis, CGR was independently associated with PFS (p < 0.001) and OS (p < 0.001). Despite higher-stage disease and greater tumor burden, CGR rates, PFS and OS for patients who underwent PDS increased over a 13-year period. Surgical paradigm shifts implemented specifically to achieve more complete surgical cytoreduction are likely the reason for these improvements. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6247423/pdf http://www.gynecologiconcology-online.net/article/S0090825818311314/pdf |
| Ending Page | 31 |
| Page Count | 8 |
| Starting Page | 24 |
| ISSN | 00908258 |
| e-ISSN | 10956859 |
| DOI | 10.1016/j.ygyno.2018.08.014 |
| Journal | Gynecologic Oncology |
| Issue Number | 1 |
| Volume Number | 151 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-08-17 |
| Access Restriction | Open |
| Subject Keyword | Journal: Gynecologic Oncology Obstetrics and Gynecology Ovarian Cancer Complete Gross Resection Primary Debulking Surgery Surgical Paradigm Progression-free Survival Overall Survival |
| Content Type | Text |
| Resource Type | Article |
| Subject | Oncology Obstetrics and Gynecology |
