Platinum-based chemotherapy of high-risk stage I epithelial ovarian cancer following comprehensive surgical staging

1994 ◽  
Vol 45 (2) ◽  
pp. 202-202
Author(s):  
S.C. Rubin ◽  
G.Y.C. Wong ◽  
J.P. Curtin ◽  
R.R. Barakat ◽  
T.B. Hakes ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
High Risk ◽  
Epithelial Ovarian Cancer ◽  
Stage I ◽  
Surgical Staging ◽  
Platinum Based Chemotherapy

Outcome of patients with early ovarian cancer undergoing three courses of adjuvant chemotherapy following complete surgical staging

2005 ◽  
Vol 15 (4) ◽  
pp. 601-605 ◽  
Author(s):  
M. Shimada ◽  
J. Kigawa ◽  
Y. Kanamori ◽  
H. Itamochi ◽  
T. Oishi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Surgical Staging ◽  
High Risk Patients ◽  
Platinum Based Chemotherapy ◽  
Early Ovarian Cancer ◽  
Risk Patients ◽  
Stage Ia

We conducted the present study to determine the outcome of patients with early ovarian cancer who underwent three courses of adjuvant chemotherapy after complete surgical staging. One hundred consecutive patients with stage I–II epithelial ovarian cancer who had undergone complete surgical staging and received three courses of platinum-based chemotherapy were entered in this study. Twenty-one patients were low risk, defined as stage IA–B, grade 1 and histologic types except for clear cell adenocarcinoma, and remaining 79 were high risk. All patients with stage IA or IB, whatever histologic type and histopathologic grade, were alive without disease. The 5-year survival rate was 89.4% for patients with stage IC and 76.2% for those with stage II. The 5-year survival rate for low- and high-risk patients was 100% and 89.4%, respectively. The survival rate for grade 1 was significantly better than that for grade 2 or 3. Multivariate analysis revealed that histologic grade was an independent prognostic factor in stage IC–II ovarian cancer. The outcome of patients with early ovarian cancer undergoing three courses of chemotherapy after complete surgical staging was favorable even in high-risk patients

Is There a High-Risk Subgroup of Stage I Epithelial Ovarian Cancer That Is Most Likely to Benefit From 6 Versus 3 Cycles of Adjuvant Chemotherapy?

2010 ◽  
Vol 20 (7) ◽  
pp. 1125-1131 ◽  
Author(s):  
Jamie N. Bakkum-Gamez ◽  
Debra L. Richardson ◽  
Leigh G. Seamon ◽  
Giovanni D. Aletti ◽  
Cecelia A. Powless ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Stage I

Incidence of Lymph Node Metastases in Apparent Early-Stage Low-Grade Epithelial Ovarian Cancer: A Comprehensive Review

2016 ◽  
Vol 26 (8) ◽  
pp. 1407-1414 ◽  
Author(s):  
Victor Lago ◽  
Lucas Minig ◽  
Christina Fotopoulou
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Epithelial Ovarian Cancer ◽  
Retrospective Studies ◽  
Early Stage ◽  
Stage I ◽  
Surgical Staging ◽  
Low Grade ◽  
Early Stage Disease ◽  
True Incidence

ObjectivesThis study aimed to determine the incidence of lymph node (LN) metastases in presumed stage I-II low-grade epithelial ovarian cancer (EOC).MethodsEligible studies were identified from MEDLINE and EMBASE (time frame, 2015–1975), that analyzed patients with clinical or radiologic presumed early-stage EOC who underwent a complete pelvic and para-aortic lymphadenectomy as part of their surgical staging. The number and site of dissected and involved LNs and the correlation with overall outcome are analyzed. The termlow gradeand also the older termwell differentiatedwere used.ResultsThirteen of 978 identified studies were selected, and 13 of 75 studies were identified as eligible. A total of 1403 patients were analyzed in these 13 retrospective studies. The final International Federation of Gynecology and Obstetrics staging after completed surgical staging was I to II in 912 patients (65%). A total of 338 patients (24%) had grade 1 tumors whereas 473 patients (34%) had grade 2, and 502 patients (36%) had grade 3 tumors. Systematic lymphadenectomy was performed in 1159 patients (83%), whereof 1142 (82%) were pelvic and para-aortic LN dissections.In 185 patients (13%), an upstaging from an apparent clinical stage I-II to IIIC occurred because of LN involvement: 64 (35%) of the patients had only pelvic LNs metastases, 69 (37%) had only para-aortic LNs metastasis, and 51 (28%) had both a pelvic and para-aortic LN involvement. When analyzing only the patients with low-grade (grade 1 as the old classification) presumed early-stage disease (n = 273), only 8 patients (2.9%; range, 0–6.2) were identified with LNs metastases present.ConclusionsThe incidence of occult LN metastases in apparent early-stage low-grade EOC is 2.9% in a metaanalysis of retrospective studies. Future larger-scale prospectively assessed studies with established surgical quality of the LN dissection are warranted to establish the true incidence of LN metastasis in presumed early low-grade disease.

Can Patients With Relapsed, Previously Untreated, Stage I Epithelial Ovarian Cancer Be Successfully Treated With Salvage Therapy?

2003 ◽  
Vol 21 (16) ◽  
pp. 3113-3118 ◽  
Author(s):  
Desiree F. Kolomainen ◽  
Roger A’Hern ◽  
Fareeda Y. Coxon ◽  
Cyril Fisher ◽  
D. Michael King ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Salvage Chemotherapy ◽  
Ovarian Neoplasm ◽  
Stage I ◽  
European Organization ◽  
Platinum Based Chemotherapy ◽  
Salvage Rate

Purpose: The role of adjuvant chemotherapy in early-stage epithelial ovarian cancer (EOC) has been controversial. We have previously reported the cases of patients managed with a policy of observation only. We now present the salvage rate for the patients in that study who experienced relapse. Patients and Methods: One hundred ninety-four patients with stage I EOC presenting between 1980 and 1994 received no adjuvant chemotherapy, but were treated with platinum-based chemotherapy at relapse. We calculated the progression-free survival (PFS) and overall survival (OS) for the whole cohort and the salvage rate for those who experienced relapse. We defined salvage as freedom from relapse for 5 years after platinum treatment. Results: Sixty-one (31%) of 194 patients experienced relapse, and 55 received platinum-based chemotherapy. Twenty-four percent were progression-free at 5 years after this treatment. Clear-cell histology and cyst rupture before the patients’ original surgery were independent prognostic factors for PFS after salvage chemotherapy. The OS for all 194 patients is 72% at 10 years (median follow-up, 8.7 years), with an 80% disease-specific survival (DSS). Conclusion: We have shown that some patients with stage I EOC can be successfully treated with a salvage chemotherapy regimen after a policy of observation only. Interestingly, approximately 30% of stage I patients who die within 10 years do so from causes other than EOC (OS, 72%; DSS, 80%). Our findings need to be taken into consideration when the results from recent randomized trials of adjuvant chemotherapy in this patient population (International Collaborative Ovarian Neoplasm Trial 1/European Organization for Research and Treatment of Cancer Adjuvant Chemotherapy in Ovarian Neoplasm Trial) are being discussed with patients.

Can we predict a high risk group in stage I epithelial ovarian cancer?

1993 ◽  
Vol 3 (4) ◽  
pp. 226-230 ◽  
Author(s):  
C. B. Finn ◽  
J. Dunn ◽  
E. J. Buxton ◽  
D. M. Luesley ◽  
M. Shafi
Keyword(s):  
Ovarian Cancer ◽  
High Risk ◽  
Epithelial Ovarian Cancer ◽  
Risk Group ◽  
High Risk Group ◽  
Stage I ◽  
Independent Effect ◽  
Independent Variables ◽  
Peritoneal Washings ◽  
Invasive Epithelial Ovarian Cancer

A retrospective review of 373 patients with stage I invasive epithelial ovarian cancer was undertaken over a 5 year period to develop a model to characterize the patient at high risk. Actuarial 5-year survival was 70%. To identify factors with an independent effect on 5-year survival, a logistic regression analysis was performed. Adjuvant chemotherapy, histologic grade and peritoneal washings, were identified as independent variables. A model to determine the predictivity of survival was created using a learning sample (2/3 of the cases) and the model was then used to reclassify a validation sample (1/3 of the cases). Using all the independent variables, outcome was predicted correctly in 78% of cases. However the model failed to improve identification of those at risk of recurrence (specificity of 53%).

Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer: a comparison of feasibility and safety

2008 ◽  
Vol 18 (6) ◽  
pp. 1202-1209 ◽  
Author(s):  
J.-Y. Park ◽  
J. Bae ◽  
M. C. Lim ◽  
S. Y. Lim ◽  
S.-S. Seo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Prospective Trial ◽  
Operating Time ◽  
Stage I ◽  
Surgical Staging ◽  
Laparoscopic Staging ◽  
Laparoscopy Group ◽  
Estimated Blood Loss ◽  
Laparotomy Group

The aim of this study was to compare laparoscopic and laparotomic surgical staging in patients with stage I epithelial ovarian cancer in terms of feasibility and safety. A retrospective chart review was undertaken of all patients with apparent stage I epithelial ovarian cancer who underwent laparoscopic (laparoscopy group) or laparotomic (laparotomy group) surgical staging at the Center for Uterine Cancer, National Cancer Center, Korea, between January 2001 and August 2006. During the study period, 19 patients underwent laparotomic surgical staging and 17 patients underwent laparoscopic surgical staging. No cases were converted from laparoscopy to laparotomy. The two groups were similar in terms of age, body mass index, procedures performed, number of lymph nodes retrieved, and operating time. The laparoscopy group had less estimated blood loss (P= 0.001), faster return of bowel movement (P< 0.001), and a shorter postoperative hospital stay (P= 0.002) compared to the laparotomy group. Transfusions were required only in two laparotomy patients, and postoperative complications occurred only in four laparotomy patients. However, two patients with stage IA grade 1 and 2 disease in laparoscopy group had recurrence with one patient dying of disease. The accuracy and adequacy of laparoscopic surgical staging were comparable to laparotomic approach, and the surgical outcomes were more favorable than laparotomic approach. However, the oncologic safety of laparoscopic staging was not certain. This is the first report on the possible hazards of laparoscopic staging in early-stage ovarian cancer. In the absence of a large prospective trial, this technique should be performed cautiously.

Adjuvant oral alkylating chemotherapy in patients with stage I epithelial ovarian cancer

Cancer ◽  
1989 ◽  
Vol 63 (6) ◽  
pp. 1070-1073 ◽  
Author(s):  
Holly H. Gallion ◽  
John R. van Nagell ◽  
Elvis S. Donaldson ◽  
Robert V. Higgins ◽  
Deborah E. Powell ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Stage I
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