The potential role of neoadjuvant chemotherapy in advanced ovarian cancer

2003 ◽  
Vol 13 (s2) ◽  
pp. 163-168 ◽  
Author(s):  
M. Baekelandt
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Potential Role ◽  
Advanced Ovarian Cancer

The potential role of neoadjuvant chemotherapy in advanced ovarian cancer

2003 ◽  
Vol 13 (Suppl 2) ◽  
pp. 163-168 ◽  
Author(s):  
M. Baekelandt
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Potential Role ◽  
Performance Status ◽  
Advanced Ovarian Cancer ◽  
Poor Performance ◽  
Residual Tumor ◽  
Poor Performance Status ◽  
Debulking Surgery

There is a multitude of evidence from retrospective analyses and meta-analyses showing that the amount of residual tumor after debulking surgery and before chemotherapy is one of the most powerful prognostic determinants in advanced ovarian cancer. This supports the important role of maximum cytoreductive surgery as one of the cornerstones in the treatment of this disease. These same analyses, however, do not suggest that patients whose tumors cannot be debulked optimally derive a significant survival benefit from upfront surgery. For these patients and those who have a poor performance status or other morbidity, making comprehensive upfront surgery contraindicated, different therapeutic approaches have to be explored. One possible way to go is to change the timing of the different therapeutic modalities: upfront chemical cytoreduction, followed by a maximal surgical effort, in turn followed by the remainder of the first-line chemotherapy or neoadjuvant chemotherapy and interval or delayed debulking surgery. The potential role of this approach and the experience with it thus far are discussed.

scholarly journals Role of Lymphadenectomy During Interval Debulking Surgery Performed After Neoadjuvant Chemotherapy in Patients With Advanced Ovarian Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Minjun He ◽  
Yuerong Lai ◽  
Hongyu Peng ◽  
Chongjie Tong
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Debulking Surgery ◽  
Hazard Ratios ◽  
Significant Difference ◽  
Interval Debulking Surgery

ObjectiveThe role of lymphadenectomy in interval debulking surgery (IDS) performed after neoadjuvant chemotherapy (NACT) in advanced ovarian cancer remains unclear. We aimed to investigate the clinical significance of lymphadenectomy in IDS.MethodsWe retrospectively reviewed and analyzed the data of patients with advanced ovarian cancer who underwent NACT followed by IDS.ResultsIn 303 patients receiving NACT-IDS, lymphadenectomy was performed in 127 (41.9%) patients. One hundred and sixty-three (53.8%) patients achieved no gross residual disease (NGRD), and 69 (22.8%) had residual disease < 1 cm, whereas 71 (23.4%) had residual disease ≥ 1cm. No significant difference in progression-free survival (PFS) and overall survival (OS) was observed between the lymphadenectomy group and the no lymphadenectomy group in patients with NGRD, residual disease < 1 cm, and residual disease ≥ 1 cm, respectively. The proportions of pelvic, para-aortic and distant lymph node recurrence were 7.9% (10/127), 4.7% (6/127) and 5.5% (7/127) in the lymphadenectomy group, compared with 5.7% (10/176, P = 0.448), 4.5% (8/176, P = 0.942) and 5.1% (9/176, P = 0.878), respectively, in no lymphadenectomy group. Multivariate analysis identified residual disease ≥ 1 cm [hazard ratios (HR), 4.094; P = 0.008] and elevated CA125 levels after 3 cycles of adjuvant chemotherapy (HR, 2.883; P = 0.004) were negative predictors for OS.ConclusionLymphadenectomy may have no therapeutic value in patients with advanced ovarian cancer underwent NACT-IDS. Our findings may help to better the therapeutic strategy for advanced ovarian cancer. More clinical trials are warranted to further clarify the real role of lymphadenectomy in IDS.

scholarly journals The role of neoadjuvant chemotherapy in the management of advanced ovarian cancer ingeriatric patients

2016 ◽  
Vol 14 (4) ◽  
pp. 212-221
Author(s):  
Ewelina Kojs-Pasińska ◽  
◽  
Bożena Cybulska-Stopa ◽  
Krzysztof Koper ◽  
Konrad Dziobek ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Ovarian Cancer

The potential role of immune regulation in the presentation of early vs. advanced ovarian cancer

2012 ◽  
Vol 127 (1) ◽  
pp. S14
Author(s):  
K. Harris ◽  
T. Kiet ◽  
I. Amanam ◽  
L. Chen ◽  
R. Brooks ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Immune Regulation ◽  
Potential Role ◽  
Advanced Ovarian Cancer

Surgical complexity score and role of laparoscopy in women with advanced ovarian cancer treated with neoadjuvant chemotherapy

2019 ◽  
Vol 152 (3) ◽  
pp. 554-559 ◽  
Author(s):  
Brittany A. Davidson ◽  
Gloria Broadwater ◽  
Aleia Crim ◽  
Robert Boccacio ◽  
Kristin Bixel ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Complexity Score ◽  
Surgical Complexity

Is There a Role for Laparoscopy in Ovarian Cancer?

2021 ◽  
pp. 176-193
Author(s):  
Stefano Angioni ◽  
Elisabetta Corvetto ◽  
Michele Peiretti ◽  
Gianmarco D'Ancona ◽  
Maurizio Nicola D'Alterio
Keyword(s):  
Ovarian Cancer ◽  
Cancer Treatment ◽  
Diagnostic Laparoscopy ◽  
Potential Role ◽  
Advanced Ovarian Cancer ◽  
Current Evidence ◽  
Benign Diseases ◽  
Therapeutic Setting ◽  
1960S And 1970S

During 1960s and 1970s, the first laparoscopic procedures concerned the treatment of benign diseases. Today the indications have significantly increased even in ovarian borderline tumours and in ovarian cancer. Furthermore, the role of diagnostic laparoscopy remains apparent in the overall therapeutic setting of advanced ovarian cancer as well. The chapter aims to summarize current evidence regarding potential role of laparoscopy in ovarian cancer treatment as well as indicate potential difficulties its usage may pose.

scholarly journals Role of diagnostic laparoscopy in patients with large cell neuroendocrine carcinoma of the ovary with cancerous peritonitis: case report and review of the literature

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Hideaki Tsuyoshi ◽  
Kenji Yashiro ◽  
Shizuka Yamada ◽  
Makoto Yamamoto ◽  
Toshimichi Onuma ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Neuroendocrine Carcinoma ◽  
Cytoreductive Surgery ◽  
Diagnostic Laparoscopy ◽  
Early Stage ◽  
Advanced Ovarian Cancer ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma

Abstract Background Large cell neuroendocrine carcinoma is a very rare ovarian neoplasm that has a poor clinical outcome even in the early stage, and there is as yet no established treatment. Diagnostic laparoscopy has been used to determine the possibility of primary optimal cytoreductive surgery or neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. However, the role of diagnostic laparoscopy is still unclear in large cell neuroendocrine carcinoma due to its rarity. Case presentation A 31-year-old woman with abdominal distention was referred to our hospital. She was strongly suspected of having advanced ovarian cancer because of a huge pelvic mass, massive ascites, and their appearance on medical imaging. However, cytological examinations from ascitic fluid by abdominal paracentesis did not show any malignant cells. She underwent diagnostic laparoscopy to evaluate the possibility of primary optimal cytoreductive surgery, and only tissue sampling was performed for pathological diagnosis because of the countless disseminated lesions of various sizes in the intraperitoneal organs. The patient had no postoperative complications, leading to the early start of postoperative chemotherapy. Conclusions To date, there have been no systematic reviews that focused on determining the treatment strategy using laparoscopy. Diagnostic laparoscopy can be helpful to determine the optimal treatment, including primary debulking surgery, neoadjuvant chemotherapy, or best supportive care, assisting in decision-making particularly for patients with advanced large cell neuroendocrine carcinoma with carcinomatous peritonitis.

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