CA125 level as a predictor of progression-free survival and overall survival in ovarian cancer patients with surgically defined disease status prior to the initiation of intraperitoneal consolidation therapy

2007 ◽  
Vol 104 (1) ◽  
pp. 176-180 ◽  
Author(s):  
Margrit M. Juretzka ◽  
Richard R. Barakat ◽  
Dennis S. Chi ◽  
Alexia Iasonos ◽  
Jakob Dupont ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Disease Status ◽  
Consolidation Therapy ◽  
Free Survival ◽  
Ca125 Level

scholarly journals A descriptive report of outcomes of primary mucinous ovarian cancer patients receiving either an adjuvant gynecologic or gastrointestinal chemotherapy regimen

2019 ◽  
Vol 29 (5) ◽  
pp. 904-909
Author(s):  
Brooke A Schlappe ◽  
Qin C Zhou ◽  
Roisin O'Cearbhaill ◽  
Alexia Iasonos ◽  
Robert A Soslow ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Free Survival ◽  
Exact Test ◽  
Clinical Criteria ◽  
Kaplan Meier

ObjectiveWe described progression-free survival and overall survival in patients with primary mucinous ovarian cancer receiving adjuvant gynecologic versus gastrointestinal chemotherapy regimens.MethodsWe identified all primary mucinous ovarian cancer patients receiving adjuvant gynecologic or gastrointestinal chemotherapy regimens at a single institution from 1994 to 2016. Gynecologic pathologists using strict pathologic/clinical criteria determined diagnosis. Adjuvant therapy was coded as gynecologic or gastrointestinal based on standard agents and schedules. Clinical/pathologic/treatment characteristics were recorded. Wilcoxon rank-sum test was used for continuous variables, and Fisher’s exact test for categorical variables. Progression-free and overall survival were calculated using the Kaplan-Meier method, applying landmark analysis.ResultsOf 62 patients identified, 21 received adjuvant chemotherapy: 12 gynecologic, 9 gastrointestinal. Median age (in years) at diagnosis: 58 (range 25–68) gynecologic cohort, 38 (range 32–68) gastrointestinal cohort (p=0.13). Median body mass index at first post-operative visit: 25 kg/m2(range 18–31) gynecologic cohort, 23 kg/m2(range 18–31) gastrointestinal cohort (p=0.23). History of smoking: 6/12 (50%) gynecologic cohort, 3/9 (33%) gastrointestinal cohort (p=0.66). Stage distribution in gynecologic and gastrointestinal cohorts, respectively: stage I: 9/12 (75%) and 3/9 (33%); stage II: 2/12 (17%) and 1/9 (11%); stage III: 1/12 (8%) and 5/9 (56%) (p=0.06). Grade distribution in gynecologic and gastrointestinal cohorts, respectively: grade 1: 8/12 (67%) and 1/9 (13%); grade 2/3: 4/12 (33%) and 7/9 (88%) (p=0.03). Three-year progression-free survival: 90.9% (95% CI 50.8% to 98.7 %) gynecologic, 53.3% (95% CI 17.7% to 79.6%) gastrointestinal. Three-year overall survival: 90.9% (95% CI 50.8% to 98.7%) gynecologic, 76.2% (95% CI 33.2% to 93.5%) gastrointestinal.ConclusionOngoing international collaborative research may further define associations between chemotherapy regimens and survival.

scholarly journals Management of the Elderly Patients with High-Grade Serous Ovarian Cancer in the REAL-WORLD Setting

2021 ◽  
Vol 28 (2) ◽  
pp. 1143-1152
Author(s):  
Michalis Liontos ◽  
Alkistis Papatheodoridi ◽  
Angeliki Andrikopoulou ◽  
Nikolaos Thomakos ◽  
Dimitrios Haidopoulos ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Optimal Treatment ◽  
High Grade ◽  
Serous Ovarian Cancer ◽  
Debulking Surgery ◽  
Free Survival

Treatment of elderly patients with neoplasia is challenging. Age is a known prognostic factor in ovarian cancer but the optimal treatment of elderly patients has not been determined. We undertook a retrospective analysis to determine clinical practice in advanced-stage ovarian cancer patients older than 70 years of age. Methods: Medical records of women with high-grade serous ovarian cancer, stage III and IV were retrospectively analyzed. Results: A total of 735 patients were identified with a median age of 61.5 years. 22.4% among them were older than 70 years of age at diagnosis. First-line Progression-Free Survival (PFS) and Overall Survival (OS) were significantly worse in elderly patients in comparison to the younger ones [mPFS 11.3 months vs. 14.8 months, (p < 0.001) and mOS 30.2 months vs. 45.6 months (p < 0.001)]. However, elderly patients were characterized by worse ECOG-Performance Status and they were more frequently treated with Neoadjuvant Chemotherapy followed by Interval Debulking Surgery, while often they were more frequently denied debulking surgery compared to patients under 70 years of age. Moreover, elderly patients received more frequently monotherapy with platinum as frontline treatment. In contrast, there was no significant difference in the outcome of the debulking surgery in comparison to the younger patients or the frequency that gBRCA test was performed. Age over 70 years did not retain its significance for either Progression-Free Survival or Overall Survival when adjusted for all other reported prognostic factors. Conclusions: Elderly ovarian cancer patients have a worse prognosis. Comprehensive geriatric assessment should be performed for the optimal treatment of these patients.

Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: A 3-year experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17094-e17094
Author(s):  
Alberto Mendivil ◽  
Lisa Nicole Abaid ◽  
John V. Brown ◽  
Kristina Mori ◽  
Katrina Lopez ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Disease Progression ◽  
Cancer Patients ◽  
Intraperitoneal Chemotherapy ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Progression Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Primary Induction

e17094 Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) potentially confers significant survival benefits in the management of ovarian cancer although the long-term data remain scant. We sought to compare the survival rates of advanced stage ovarian cancer patients who were treated with primary induction therapy alone or in conjunction with consolidation HIPEC. Methods: Sixty-nine ovarian cancer patients who underwent surgery and completed their primary induction chemotherapy were treated with consolidation carboplatin (AUC 10) based HIPEC and compared to a historical cohort that received surgery and primary chemotherapy alone (n=69). The demographic and clinical characteristics in which we were primarily interested included: patient age, body mass index, surgery and pathology data, chemotherapy regimen, toxicity, and progression free/overall survival. Results: The two patient groups were similar in terms of tumor characteristics, cyto-reductive status, distribution of neoadjuvant chemotherapy and number of maintenance chemotherapy cycles administered (P> 0.05). Progression free survival was significantly more pronounced in the HIPEC (25.1 months) patients compared to the control group (20 months) (P=0.024) and there was a decreased risk of disease progression accorded to the patients treated with HIPEC (HR, 2.1028; 95% CI: 1.2941 to 3.4167; P=0.0027). However, we did not discern any HIPEC related overall survival advantages (P=0.29). Conclusions: The results from our ovarian cancer study suggest that adjunctive HIPEC proffers a significant progression free survival advantage and a decreased risk for disease progression. There was, however, no overall survival advantage discerned in the HIPEC group. We also recognize that HIPEC remains controversial and thus, randomized studies evaluating HIPEC compared to standard chemotherapy in the management of ovarian cancer are warranted.

Intraperitoneal paclitaxel and cisplatin compared with dose-dense paclitaxel and carboplatin for patients with stage III ovarian cancer

2020 ◽  
Vol 26 (7) ◽  
pp. 1566-1574 ◽  
Author(s):  
Madison Murphy ◽  
Grace Martin ◽  
Zahra Mahmoudjafari ◽  
Cory Bivona ◽  
Dennis Grauer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Progression Free Survival ◽  
Final Analysis ◽  
Primary Objective ◽  
Stage Iii ◽  
Free Survival ◽  
Intraperitoneal Therapy ◽  
Dose Dense

Introduction Patients diagnosed with stage III ovarian cancer are at high risk of recurrence and optimal adjuvant therapy is often debated. There is limited literature that directly compares intraperitoneal paclitaxel and cisplatin with dose-dense paclitaxel and carboplatin. Objectives The primary objective was to compare progression-free survival, overall survival, and tolerability of adjuvant intraperitoneal paclitaxel and cisplatin to dose-dense paclitaxel and carboplatin in stage III ovarian cancer patients. Methods A retrospective, IRB-approved, single center chart review was conducted reviewing adult patients with stage III ovarian cancer undergoing adjuvant intraperitoneal therapy or dose-dense therapy between 2010 and 2018. Results Eighty-two patients were included in the final analysis; 44 in the intraperitoneal group and 38 in the dose-dense group. Intraperitoneal therapy was not associated with a longer progression-free survival (35.4 vs. 31.1 months; P = 0.97). The duration of overall survival did not differ between intraperitoneal and dose-dense (56.3 vs. 54.5 months; P = 0.55). Dose reductions were less frequent with intraperitoneal than dose-dense (11.36% vs. 31.58%; P = 0.02). No difference in treatment delays (45.5% vs. 65.8%; P = 0.07), dose cancellations (59.1% vs. 57.9%; P = 0.91), supportive care additions (95.5% vs. 84.2%; P = 0.09), or therapy discontinuation (59.1% vs. 39.5%; P = 0.07) between groups was noted. Conclusions Intraperitoneal therapy with paclitaxel and cisplatin, as compared with dose-dense paclitaxel and carboplatin, did not prolong progression-free or overall survival in the adjuvant setting among stage III ovarian cancer patients. A trend towards decreased tolerability was noted with intraperitoneal therapy.

Evaluation of patterns of progression on poly (ADP-ribose) polymerase inhibitor (PARPi) maintenance in ovarian cancer: a cross-sectional study

2021 ◽  
pp. ijgc-2021-003053
Author(s):  
Victoria R Cerda ◽  
Diana Lu ◽  
Marla Scott ◽  
Kenneth H Kim ◽  
Bobbie Jo Rimel ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Language Processing ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Consolidation Therapy ◽  
Cross Sectional ◽  
Free Survival ◽  
Entire Cohort ◽  
Platinum Based Chemotherapy

IntroductionDespite improvement in progression-free survival with poly (ADP-ribose) polymerase inhibitors (PARPi) as maintenance therapy for ovarian cancer, many patients will eventually progress on therapy. Oligoprogression is uniquely suited to considerations of local consolidation therapy in this setting, but not commonly used in ovarian cancer. In this study we evaluated the proportion of patients on PARPi maintenance who developed limited sites of disease, the location of progression, and their natural history.MethodsFrom January 2006 to December 2020, natural language processing software (DEEP6AI) was used to identify 58 patients with ovarian cancer treated with PARPi maintenance after complete or partial response after surgery and platinum-based chemotherapy at our institution. Patients were assessed for presence and location of recurrence based on radiologic findings.ResultsThe median patient age was 65 (IQR 57–71) years. Patients had a median of two lines of chemotherapy prior to starting PARPi. With a median follow-up of 48 (range 12–149) months, 32 (55%) patients had a recurrence on maintenance olaparib and 11 (34%) patients developed oligoprogression (≤3 sites). For the 11 patients with oligoprogression, three patients developed recurrence in one site, five in two sites, and three in three sites. The sites of oligoprogression were pelvic/periaortic nodal (27%), peritoneal (27%), liver (27%), lung/mediastinal (14%), and brain (5%). The median progression-free survival for the entire cohort was 6.0 months (95% CI 4.2 to 7.8); median overall survival was not met. There were no significant differences in overall survival (p=0.81) or progression-free survival (p=0.95) between patients with and without oligoprogression.ConclusionsOne-third of patients on PARPi maintenance experienced oligoprogression defined as limited to ≤3 sites. These patients may benefit from local consolidation therapy. A larger dataset is needed to validate these findings to assess if trials investigating local therapy for these patients is of value.

scholarly journals The Relationship Between Retroperitoneal Lymphadenectomy and Survival in Advanced Ovarian Cancer Patients

2019 ◽  
Author(s):  
Ping Zhang ◽  
Chenyan Fang ◽  
Yingli Zhang ◽  
Lingqin Zhao ◽  
Xi Chen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Retroperitoneal Lymphadenectomy ◽  
Free Survival

Abstract Background Systematic retroperitoneal lymphadenectomy has been widely used in the surgical treatment of advanced ovarian cancer patients; nevertheless, the effect remains controversial. Thus, the current study was carried out aiming to evaluate the benefit of systematic retroperitoneal lymphadenectomy in such patients with optimal cytoreduction. Methods Patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stage III-IV) admitted and treated in Zhejiang Cancer Hospital from January 2004 to December 2013 were enrolled and reviewed retrospectively. All patients were optimally debulked (residual tumor <1 cm or absent) and divided into two groups. Group A (n =170) (no-lymphadenectomy group): patients did not undergo lymph node resection; lymph nodes resection or biopsy were selective. Group B (n=240): patients underwent systematic retroperitoneal lymphadenectomy. Results A total of 410 eligible patients were enrolled in the analysis. The median age was 51 years (range: 28–72). The 5-year overall survival (OS) and 2-year progression-free survival (PFS) rates were 78% and 24% in the no-lymphadenectomy group and 76% and 26% in the lymphadenectomy group (P=0.385 and P=0.214, respectively). Subsequently, there was no significant difference in 5-year overall survival and 2-year progression-free survival between the two groups stratified to histological type (serous or non-serous type), the clinical evaluation for lymph nodes (negative) or with macroscopic peritoneal metastasis beyond pelvic (IIIB-IV). Multivariate Cox regression analysis indicated that systematic retroperitoneal lymphadenectomy was not a significant factor affecting survival of patients. Patients in the lymphadenectomy group had a higher incidence of postoperative complications (incidence of infection treated with antibiotics was 21.7% vs. 12.9% [P=0.027]; incidence of lymph cysts was 20.8% vs. 2.4% [P < 0.001]). Conclusions Our study showed that systematic retroperitoneal lymphadenectomy did not significantly improve survival in advanced ovarian cancer patients with residual tumor <1 cm or absent after cytoreductive surgery, and were associated with a higher incidence of postoperative complications.

scholarly journals Comparison of the survival outcomes of laparoscopy versus laparotomy in treatment of early-stage ovarian cancer: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qingduo Kong ◽  
Hongyi Wei ◽  
Jing Zhang ◽  
Yilin Li ◽  
Yongjun Wang
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Survival Outcomes ◽  
Free Survival ◽  
Review Manager ◽  
Early Stage Ovarian Cancer

Abstract Background Laparoscopy has been widely used for patients with early-stage epithelial ovarian cancer (eEOC). However, there is limited evidence regarding whether survival outcomes of laparoscopy are equivalent to those of laparotomy among patients with eEOC. The result of survival outcomes of laparoscopy is still controversial. The aim of this meta-analysis is to analyze the survival outcomes of laparoscopy versus laparotomy in the treatment of eEOC. Methods According to the keywords, Pubmed, Embase, Cochrane Library and Clinicaltrials.gov were searched for studies from January 1994 to January 2021. Studies comparing the efficacy and safety of laparoscopy versus laparotomy for patients with eEOC were assessed for eligibility. Only studies including outcomes of overall survival (OS) were enrolled. The meta-analysis was performed using Stata software (Version 12.0) and Review Manager (Version 5.2). Results A total of 6 retrospective non-random studies were included in this meta-analysis. The pooled results indicated that there was no difference between two approaches for patients with eEOC in OS (HR = 0.6, P = 0.446), progression-free survival (PFS) (HR = 0.6, P = 0.137) and upstaging rate (OR = 1.18, P = 0.54). But the recurrence rate of laparoscopic surgery was lower than that of laparotomic surgery (OR = 0.48, P = 0.008). Conclusions Laparoscopy and laparotomy appear to provide comparable overall survival and progression-free survival outcomes for patients with eEOC. Further high-quality studies are needed to enhance this statement.

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