Patterns of pathological response to neoadjuvant chemotherapy and its clinical implications in patients undergoing interval cytoreductive surgery for advanced serous epithelial ovarian cancer- A study by the Indian Network for Development of Peritoneal Surface Oncology (INDEPSO)

2019 ◽  
Vol 45 (4) ◽  
pp. 666-671 ◽  
Author(s):  
Aditi Bhatt ◽  
Snita Sinukumar ◽  
Sanket Mehta ◽  
Dileep Damodaran ◽  
Shabber Zaveri ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Pathological Response ◽  
Clinical Implications ◽  
Peritoneal Surface ◽  
Serous Epithelial Ovarian Cancer ◽  
Response To Neoadjuvant Chemotherapy

scholarly journals Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline

2016 ◽  
Vol 34 (28) ◽  
pp. 3460-3473 ◽  
Author(s):  
Alexi A. Wright ◽  
Kari Bohlke ◽  
Deborah K. Armstrong ◽  
Michael A. Bookman ◽  
William A. Cliby ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Clinical Oncology ◽  
Cytoreductive Surgery ◽  
Gynecologic Oncology ◽  
Phase Iii ◽  
Stage Iiic ◽  
American Society ◽  
Interval Cytoreduction

Purpose To provide guidance to clinicians regarding the use of neoadjuvant chemotherapy and interval cytoreduction among women with stage IIIC or IV epithelial ovarian cancer. Methods The Society of Gynecologic Oncology and the American Society of Clinical Oncology convened an Expert Panel and conducted a systematic review of the literature. Results Four phase III clinical trials form the primary evidence base for the recommendations. The published studies suggest that for selected women with stage IIIC or IV epithelial ovarian cancer, neoadjuvant chemotherapy and interval cytoreduction are noninferior to primary cytoreduction and adjuvant chemotherapy with respect to overall and progression-free survival and are associated with less perioperative morbidity and mortality. Recommendations All women with suspected stage IIIC or IV invasive epithelial ovarian cancer should be evaluated by a gynecologic oncologist prior to initiation of therapy. The primary clinical evaluation should include a CT of the abdomen and pelvis, and chest imaging (CT preferred). Women with a high perioperative risk profile or a low likelihood of achieving cytoreduction to < 1 cm of residual disease (ideally to no visible disease) should receive neoadjuvant chemotherapy. Women who are fit for primary cytoreductive surgery, and with potentially resectable disease, may receive either neoadjuvant chemotherapy or primary cytoreductive surgery. However, primary cytoreductive surgery is preferred if there is a high likelihood of achieving cytoreduction to < 1 cm (ideally to no visible disease) with acceptable morbidity. Before neoadjuvant chemotherapy is delivered, all patients should have confirmation of an invasive ovarian, fallopian tube, or peritoneal cancer. Additional information is available at www.asco.org/NACT-ovarian-guideline and www.asco.org/guidelineswiki .

Pathologic response to neoadjuvant chemotherapy in advanced ovarian cancer: utility of a scoring system to predict outcomes

2019 ◽  
Vol 29 (6) ◽  
pp. 1064-1071
Author(s):  
Camilla Nero ◽  
Anna Fagotti ◽  
Gian Franco Zannoni ◽  
Eleonora Palluzzi ◽  
Giovanni Scambia ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Scoring System ◽  
Prognostic Value ◽  
Pathologic Complete Response ◽  
Advanced Ovarian Cancer ◽  
Scoring Systems ◽  
Pathologic Response ◽  
Response To Neoadjuvant Chemotherapy

BackgroundGrowing evidence supports the role of neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. Currently, there is no shared histopathologic scoring system to assess pathologic response in the specimens obtained at interval surgery after neoadjuvant chemotherapy This review aims to summarize the literature on pathologic response, focusing on proposed scoring systems.MethodsThe systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, focusing on the definition of pathologic response, its prognostic value, possible predictors, and future implications. Eighteen manuscripts focusing on pathologic response in epithelial ovarian cancer were selected for analysis.ResultsOverall, eight histopathologic scoring systems to evaluate pathologic response have been proposed. There are currently no available markers (serum, radiological, genomic) to select which patients could achieve the highest benefit from neoadjuvant chemotherapy experiencing a complete pathologic response. A three-tier scoring system (CRS) based on omental assessment and which classifies the response to neoadjuvant chemotherapy has been validated in external cohorts of epithelial ovarian cancer. This scoring system demonstrated adequate interobserver reproducibility. Data is limited on the pathologic complete response rate changes according to chemotherapy regimen.ConclusionsA histopathologic scoring system endowed with prognostic value could be helpful in personalizing the treatment decision in patients with epithelial ovarian cancer.

The predictors of response to neoadjuvant chemotherapy in advanced epithelial ovarian cancer

2011 ◽  
Vol 105 (2) ◽  
pp. 200-205 ◽  
Author(s):  
Yusuf Yildirim ◽  
Ibrahim Egemen Ertas ◽  
Askin Dogan ◽  
Ozge Elmastas Gultekin ◽  
Emre Gultekin
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Predictors Of Response ◽  
Advanced Epithelial Ovarian Cancer ◽  
Response To Neoadjuvant Chemotherapy
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