Optimisation of Cytoreductive Surgery in Relation to Ca 125 in Epithelial Ovarian Cancer

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
K. Shobha ◽  
Natarajan Jayashree ◽  
U. D. Bafna
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Ca 125

Phase II study of intraperitoneal submicron particle paclitaxel (SPP) plus IV carboplatin and paclitaxel in patients with epithelial ovarian cancer undergoing cytoreductive surgery.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18046-e18046
Author(s):  
Sally Anne Mullany ◽  
David S. Miller ◽  
Katina Robison ◽  
Kimberly Levinson ◽  
Yi-Chun Lee ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Study Drug ◽  
Complete Response ◽  
Submicron Particles ◽  
Ca 125 ◽  
Local Toxicity ◽  
Nonsurgical Patients ◽  
Dose Levels

e18046 Background: Although advances in chemotherapy, cytoreductive surgery, and maintenance therapy (SOC) improved PFS for high grade epithelial ovarian cancer, > 20% of patients relapse during the first 6 months and 60% relapse after 6 months. Submicron particles (~800 nm) of paclitaxel (SPP) contain 1-2 billion molecules of pure drug that release tumoricidal levels of paclitaxel over many weeks. In a previous trial, percutaneous instillations of SPP in nonsurgical patients with intraperitoneal cancer were associated with reduced systemic and local toxicity as compared to standard chemotherapy regimens. (Williamson et al Cancer Chemo Pharm (2015) 75:1075). Methods: This study compared two dose-levels of IP SPP instilled in 200 ml of saline post-cytoreductive surgery. Eligible patients with primary (n = 6) or recurrent (n = 4) epithelial ovarian cancer who underwent complete cytoreductive surgery were enrolled to receive a single instillation of IP SPP followed by standard IV carboplatin and paclitaxel. Endpoints were PFS and evaluation of treatment-emergent adverse events. Clinical response was determined by CT scans and serum CA-125 measurements. Results: Of the 24 subjects screened, 10 were enrolled and received treatment: seven patients received 100 mg/m2 and three received 200 mg/m2. For analysis purposes, 7 out of 10 subjects were evaluable (1 withdrew, 1 died unrelated to study drug during IV treatment and 1 was unevaluable). Upon completion of planned chemotherapy post-SPP instillation, the PFS at 6 months was 66% (4/6) and at 12-months 66% (4/6) using RECIST 1.1. One subject had a complete response at the end of IV treatment, but died (unrelated to study treatment) before PFS evaluation. There was one case of incision dehiscence and one case of vaginal cuff leakage after surgery. Conclusions: This pilot study supports further evaluation of IP SPP to treat peritoneal carcinomas. Clinical trial information: NCT03029585.

The Combination of Serum Biomarker (CA-125, FASN, and GLS) as a Predictor Suboptimal Cytoreduction in Epithelial Ovarian Cancer

2020 ◽  
Author(s):  
Gatot Nyarumenteng Adhipurnawan Winarno ◽  
Yudi Mulyana Hidayat ◽  
Setiawan Soetopo ◽  
Sofie Rifayani Krisnadi ◽  
Maringan Diapari Lumban Tobing ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Cross Sectional Study ◽  
Ca 125 ◽  
Cross Sectional ◽  
Average Value ◽  
Preoperative Serum ◽  
Serum Ca125 ◽  
Sensitivity Specificity

Abstract Purpose. Cytoreduction has an important role in improving the survival rate of epithelial ovarian cancer (EOC) patients. The use of preoperative CA-125 as an optimal predictor cytoreduction in patients with ovarian cancer is still controversial. This study aimed to assess the ability of preoperative serum CA125, FASN and GLS as a predictor of cytoreductive surgery in epithelial ovarian cancer (EOC). This observational-analytic cross-sectional study included 109 women diagnosed with epithelial ovarian cancer (EOC) between 2017-2019, who had serum CA-125, GLS, FASN measured preoperatively and underwent cytoreductive surgery. Result. The average value of serum CA-125, FASN, and GLS in the suboptimal cytoreduction were higher than the optimal cytoreduction group. The cut off point (COP) of CA-125 was 248.55 (p=0.0001) with 73.2% sensitivity and 73.6% specificity, FASN was 0.445 (p=0.017) with 62.5% sensitivity and 60.4% specificity, and GLS was 22.895 (p=0.0001) with 73.2% sensitivity and 75.5% specificity. The COP value of CA-125 and GLS combined was 29.16 (p=0.0001) with sensitivity 82.1% and spesificity 73.6%, while the COP of CA-125, GLS, and FASN combined was 0.83 (p=0.0001) with 87.5% sensitivity and 73.6% specificity. If the value of biomarker serum more than COP will more likely have suboptimal cytoreductive surgery. Conclusion. The role of CA125, FASN and GLS levels in predicting suboptimal cytoreductive surgery for patients with ovarian cancer seems questionable. However, the combination of CA-125 and GLS or CA-125, FASN and GLS are able to increase the sensitivity, specificity, and accuracy classification to predict suboptimal cytoreductive surgery.

scholarly journals Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

2021 ◽  
Vol 10 (5) ◽  
pp. 1058
Author(s):  
Grégoire Rocher ◽  
Thomas Gaillard ◽  
Catherine Uzan ◽  
Pierre Collinet ◽  
Pierre-Adrien Bolze ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Cohort Analysis ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Retrospective Cohort Analysis

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

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