Influence of size of a postoperative residual tumor on survival of patients with ovarian carcinoma, treated postoperatively with chemotherapy

1993 ◽  
Vol 29 ◽  
pp. S136
Author(s):  
S. Čolaković ◽  
V. Lukić ◽  
Lj. Stamatović ◽  
J. Marinković ◽  
J. Josifovski ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Residual Tumor ◽  
Postoperative Residual

A randomized multicenter phase II study on neoadjuvant chemotherapy with carboplatin and docetaxel in advanced ovarian carcinomas (PRIMOVAR)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15025-15025 ◽  
Author(s):  
T. Park-Simon ◽  
F. Jänicke ◽  
O. Ortmann ◽  
J. Hilfrich ◽  
G. Breitbach ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Ovarian Carcinoma ◽  
Preoperative Chemotherapy ◽  
Response Rate ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Ovarian Carcinomas ◽  
Number Of Patients ◽  
Postoperative Residual

15025 Background: In the past years the concept of neoadjuvant chemotherapy and interval laparotomy has emerged for patients with advanced ovarian cancer and unfavorable prognosis (e.g. diffuse peritoneal carcinosis). In a recent study on neoadjuvant chemotherapy higher tumor resection rates and longer median survival were demonstrated in patients with advanced ovarian carcinoma and ascites >500ml. Most studies use three cycles of preoperative chemotherapy. However, chemoresistant tumorclones may be induced by increasing number of preoperative chemotherapy cycles. The purpose of this study is to evaluate the optimal number of cycles prior to interval laparotomy. Methods: 67/73 patients with advanced serous ovarian carcinoma (FIGO IIIc n = 48, FIGO IV n = 19) and ascites >500ml were randomized into two arms, receiving either 2 (n = 33) or 3 (n = 34) cycles of Carboplatin (AUC5) and Docetaxel (75mg/m2) before interval laparotomy. Postoperatively, they received either 4 or 3 additional cycles. Response rate and postoperative residual tumor were evaluated. Results: Surgical response was assessed during interval laparotomy. At present 32 patients underwent tumordebulking. Partial remission was observed in 28/32 patients irrespective of the number of preoperative chemotherapy cycles. Two patients in each arm showed stable disease. Optimal cytoreduction was achieved in 25/32 patients. No severe adverse events were reported. Six of 73 patients were not eligible. Two patients were excluded due to therapy-unrelated events. In 4 patients ovarian cancer was excluded by laparoscopy prior to neoadjuvant chemotherapy. Conclusions: Neoadjuvant chemotherapy followed by interval laparotomy was safe and well tolerated. Diagnostic laparoscopy prior to neoadjuvant chemotherapy allowed differentiation of primary ovarian cancers from tumors of other origin. In these cases laparotomy could be circumvented. Optimal tumor reduction was achieved in a significant number of patients. Response rate and postoperative residual tumor were essentially the same in both arms. Our data indicate that two cycles of preoperative chemotherapy may be the preferential choice of therapy for future studies. No significant financial relationships to disclose.

Analysis of postoperative radiation therapy in stage I through III epithelial ovarian carcinoma.

1987 ◽  
Vol 5 (6) ◽  
pp. 897-905 ◽  
Author(s):  
D B Fuller ◽  
W T Sause ◽  
H P Plenk ◽  
R L Menlove
Keyword(s):  
Ovarian Carcinoma ◽  
Open Field ◽  
Residual Disease ◽  
Postoperative Radiotherapy ◽  
Statistical Significance ◽  
Residual Tumor ◽  
Epithelial Ovarian Carcinoma ◽  
Postoperative Radiation Therapy ◽  
Curative Therapy ◽  
Postoperative Residual

A retrospective long-term analysis of the results of primary postoperative radiotherapy in 106 women with invasive epithelial ovarian carcinoma is presented. Forty-two women received open-field total abdominopelvic irradiation, and 64 received treatment by various subtotal abdominopelvic techniques. The mean follow-up of living patients in the two groups is 86 and 116 months, respectively. Women who had Federation International Gynecology and Oncology (FIGO) stages I through III-A with no postoperative residual disease, or less than 0.5-cm abdominal and/or less than 2-cm pelvic residual disease formed a favorable group in whom total abdominopelvic irradiation resulted in a 71% 10-year actuarial relapse-free survival rate compared with 40% for those treated by subtotal abdominopelvic techniques (P less than or equal to .0205). The survival improvement due to the total abdominopelvic technique in favorable patients became even more significant (P less than or equal to 0.003) after adjusting for differences in stage, grade, and postoperative residual disease volume (no, or favorable, gross). Increasing grade appeared to be associated with decreasing survival even among favorable patients treated with the optimal technique, although the differences did not approach statistical significance after adjusting for residual disease volume and stage. Surgical bowel complications were equivalent, 7.1% for total abdominopelvic v 8.1% for subtotal abdominopelvic techniques. The addition of intraperitoneal radioactive chromic phosphate increased the surgical bowel complication rate 33% over external pelvic irradiation alone without improving survival. Patients with unfavorable gross residual disease and/or FIGO stages III-B and IV were incurable by any radiation technique. Those with no, or favorable, gross residual tumor constitute a group in whom we believe open-field total abdominopelvic irradiation represents a potentially curative therapy modality.

Significance of epidermal growth factor receptor in advanced ovarian cancer.

1992 ◽  
Vol 10 (4) ◽  
pp. 529-535 ◽  
Author(s):  
G Scambia ◽  
P Benedetti Panici ◽  
F Battaglia ◽  
G Ferrandina ◽  
G Baiocchi ◽  
...  
Keyword(s):  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Growth Factor Receptor ◽  
Residual Tumor ◽  
Primary Tumors ◽  
Primary Surgery ◽  
Risk Of Progression ◽  
Epidermal Growth ◽  
Postoperative Residual

PURPOSE The purpose of this study was to investigate the significance of epidermal growth factor receptor (EGF-R) expression in a group of advanced ovarian carcinomas. PATIENTS AND METHODS The study was conducted on 72 previously untreated patients with International Federation of Gynecology and Obstetrics (FIGO) stage III-IV disease. The median follow-up was 24 months (range, 4 to 75 months). EGF-R was measured by a radioreceptorial assay. A cutoff of 1.5 fmol per milligram of protein was chosen to define EGF-R positivity. Medians and life tables obtained with the Kaplan and Meier method were analyzed by the log-rank test. The risk of progression was estimated by Cox's proportional hazards model. RESULTS EGF-R was detected in 54% of primary tumors. When EGF-R was analyzed in different tissue specimens of the same tumor, consistent findings were noted in 88% (seven of eight) of cases. A lower concordance rate (nine of 15; 60%) was found between primary tumors and omental metastases, with a tendency toward higher EGF-R levels in the latter. The EGF-R expression did not significantly correlate with age, stage, grading, and residual tumor after primary surgery. In the univariate analysis, stage IV disease, postoperative residual tumor diameter greater than 2 cm, presence of ascites, and EGF-R positivity were found to be significantly associated with a greater risk of disease progression. In the multivariate analysis, only the postoperative residual tumor and the EGF-R expression remained significantly associated with a high risk of progression. CONCLUSION Data reported here suggest that the presence of EGF-R in advanced ovarian tumor at the time of the primary surgery identifies a subset of patients with a particularly poor prognosis.

Randomized trial comparing two combination chemotherapy regimens (CHAP-5 v CP) in advanced ovarian carcinoma.

1987 ◽  
Vol 5 (8) ◽  
pp. 1157-1168 ◽  
Author(s):  
J P Neijt ◽  
W W ten Bokkel Huinink ◽  
M E van der Burg ◽  
A T van Oosterom ◽  
P H Willemse ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Therapeutic Index ◽  
Residual Tumor ◽  
Figo Stage ◽  
Gynecology And Obstetrics ◽  
Adequate Hydration ◽  
Karnofsky Index

One hundred ninety-one patients with advanced epithelial ovarian carcinoma were treated with either a combination of doxorubicin and a five-day course of cisplatin alternating with cyclophosphamide and hexamethylmelamine orally for 14 days (CHAP-5) or cyclophosphamide and cisplatin both administered intravenously (IV) on a single day at 3-week intervals (CP). At a median follow-up time of 45 months, treatment with each of these combinations resulted in the same remission rates (80% and 74%, respectively) and exactly the same progression-free survival and overall survival (median, 26 months). Despite adequate hydration, more renal toxicity was encountered in the CP-treated patients than in those who received CHAP-5. Disabling neurotoxicity and severe myelosuppression were encountered more frequently in the patients treated with CHAP-5. Because the toxicity was lower and CP treatment required shorter hospitalization, the single-day regimen was considered preferable for future use. The Karnofsky index was the only independent predictor for response, whereas both this index and the size of residual tumor before chemotherapy were predictive of survival. After correcting for other prognostic factors, it was determined that tumor size associated with improved survival was less than 1 cm. The site of metastases in International Federation of Gynecology and Obstetrics (FIGO) stage IV patients did not influence survival within this category. The results of this study confirm our previous findings that patients with microscopic remnants at second-look have a survival similar to that of patients who are histopathologically free of disease. This makes the significance of so-called pathologically confirmed complete remission questionable. The survival benefit of debulking surgery performed during chemotherapy seems only minimal for patients in whom debulking has already been attempted before treatment. Like others, we have found the CP regimen to have a good therapeutic index.

scholarly journals Preoperative Predictors for Residual Tumor after Surgery in Patients with Ovarian Carcinoma

Oncology ◽  
2007 ◽  
Vol 72 (5-6) ◽  
pp. 293-301 ◽  
Author(s):  
D. de Jong ◽  
M.J. Eijkemans ◽  
S. Lie Fong ◽  
C.G. Gerestein ◽  
G.S. Kooi ◽  
...  
Keyword(s):  
Ovarian Carcinoma ◽  
Residual Tumor ◽  
Preoperative Predictors

The prognostic significance of postoperative residual tumor in ependymoma

Neurosurgery ◽  
1991 ◽  
pp. 666 ◽  
Author(s):  
E A Healey ◽  
P D Barnes ◽  
W J Kupsky ◽  
R M Scott ◽  
S E Sallan ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
Residual Tumor ◽  
Postoperative Residual

Caspase-cleaved cytokeratin 18 fragment (M30) as marker of postoperative residual tumor load in colon cancer patients

2009 ◽  
Vol 35 (11) ◽  
pp. 1164-1168 ◽  
Author(s):  
C. Ausch ◽  
V. Buxhofer-Ausch ◽  
U. Olszewski ◽  
W. Hinterberger ◽  
E. Ogris ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Residual Tumor ◽  
Cytokeratin 18 ◽  
Tumor Load ◽  
Postoperative Residual

Clinical Value of Radioimmunoscintigraphy in the follow-up of Ovarian Carcinoma: A Prospective Study

1990 ◽  
Vol 5 (3) ◽  
pp. 103-108 ◽  
Author(s):  
F. Crippa ◽  
M. Presti ◽  
A. Marini ◽  
B. D'Onofrio ◽  
G. Bolis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Residual Tumor ◽  
Clinical Value ◽  
Second Look ◽  
Tumor Persistence ◽  
Upper Abdominal ◽  
Abdominal Lesions ◽  
A Prospective Study

Twenty-five patients treated with debulking surgery and chemotherapy for ovarian cancer were prospectively studied to evaluate the efficacy of radioimmunoscintigraphy (RIS) in detecting residual tumor before second-look surgery. RIS was performed with the monoclonal antibody OC125 F(ab')2 labelled with 1-131 without knowledge of clinical data and compared with subsequent surgical results. Second look showed tumor persistence in 12 patients, mostly characterized by small lesions. The overall diagnostic sensitivity of RIS was 50% and the specificity was 85%. In particular, RIS showed better sensitivity for pelvic tumor localizations than for abdominal sites (73% vs 33%); this was due to the inability of RIS to detect upper abdominal lesions. Therefore, our conclusion is that, at present, RIS cannot substitute surgical second-look in the management of ovarian cancer, however, considering that also ultrasonography, computer tomography and magnetic resonance are not always able to give definite diagnostic evidence in the follow-up of ovarian carcinoma, RIS could be added to these procedures to balance the limitations of each method. In this regard, the best application of RIS could be in the follow-up of patients with marker elevation without clinical evidence of disease, especially in the case of pelvic fibrosis or adhesions due to previous therapy, where the other non-invasive tools can give doubtful diagnostic results.

Role of laparoscopy to evaluate candidates for complete cytoreduction in advanced stages of epithelial ovarian cancer

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 35-40 ◽  
Author(s):  
X. Deffieux ◽  
D. Castaigne ◽  
C. Pomel
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Preoperative Evaluation ◽  
Residual Tumor ◽  
Complete Cytoreduction ◽  
Advanced Stages ◽  
Laparoscopic Evaluation ◽  
Cancer Laparoscopy

The objective of this study was to evaluate the role of laparoscopy in selecting candidates for complete cytoreduction surgery in epithelial ovarian carcinoma. We performed an explorative laparoscopy in 15 women presenting with advanced ovarian carcinoma, and for whom the preoperative evaluation was considered unsatisfactory, to define the possibility of achieving a complete cytoreduction. We focused on three sites of carcinomatosis: bowel, liver pedicle, and right diaphragmatic dome. Laparoscopic evaluation was successful in all 15 patients. Four patients were considered to have unresectable carcinomatosis because of extensive involvement of the small bowel and therefore had no laparotomy. These women underwent neoadjuvant chemotherapy in the following 2 weeks. Eleven patients were considered to have resectable peritoneal carcinomatosis (PC). Ten women had no macroscopic residual tumor after surgery. A modified posterior exenteration was performed in five patients. The laparoscopic exploration had underestimated the liver pedicle involvement in two patients, but only one had an infracentimetric residual tumor after surgery. Laparoscopy is a reliable method of exploring PC in advanced-stage ovarian cancer. Laparoscopy may obviate the need for unnecessary laparotomy in many cases and may, therefore, contribute to a better quality of life for patients found to have unresectable disease.

Sign in / Sign up

Export Citation Format

Share Document