scholarly journals Complete tumor resection and demonstration of detailed anatomy of the porta hepatis in a patient with recurrent epithelial ovarian cancer

2020 ◽  
Vol 31 (1) ◽  
pp. 148-149
Author(s):  
Cagatay Taskiran ◽  
Dogan Vatansever ◽  
Selim Misirlioglu ◽  
Burak Giray ◽  
Tuncer Kumcular ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Tumor Resection ◽  
Porta Hepatis ◽  
Complete Tumor Resection ◽  
Complete Tumor

TRUST: Trial of radical upfront surgical therapy in advanced ovarian cancer (ENGOT ov33 / AGO‐OVAR OP7).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. TPS5602-TPS5602 ◽  
Author(s):  
Sven Mahner ◽  
Florian Heitz ◽  
Alexander Burges ◽  
Alexander Reuss ◽  
Bernhard Kraemer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Surgical Therapy ◽  
Tumor Resection ◽  
Advanced Ovarian Cancer ◽  
Phase Iii ◽  
Surgical Morbidity ◽  
Complete Tumor Resection ◽  
Surgical Quality ◽  
Platinum Based Chemotherapy ◽  
Complete Tumor

TPS5602 Background: Primary cytoreductive surgery (PDS) followed by chemotherapy has been considered as standard management for advanced ovarian cancer patients (pts) over decades. An alternative approach of interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT) was subsequently reported by two randomized phase III trials (EORTC‐GCG, CHORUS). Owing to important limitations of these studies, especially regarding surgical quality, optimal timing of surgical therapy in advanced ovarian cancer is still unclear. Methods: TRUST is an international open, randomized, controlled multicenter trial investigating overall survival (OS; primary endpoint) after PDS vs NACT and subsequent IDS in pts with FIGO stage IIIB‐IVB ovarian, tubal, and peritoneal carcinoma. Secondary objectives are safety of complete tumor resection, progression‐free survival and quality of life (QoL) as well as surgical morbidity. In order to guarantee adequate surgical quality, participating centers need to fulfill specific quality assurance criteria (e.g. ≥50% complete resection rate in upfront surgery for FIGO IIIB-IV pts, ≥36 debulking-surgeries/year) and agree to independent audits by TRUST Quality committee delegates. A 1:1 randomization to PDS or NACT followed by IDS stratified by center and age‐ECOG combination (ECOG 0 and age ≤65 years vs ECOG > 0 or age > 65 years) is performed. Pts in the PDS arm will undergo surgery followed by 6 cycles of platinum-based chemotherapy, whereas pts in the IDS arm will be treated with 3 cycles of NACT after histologic confirmation of the disease, followed by IDS and subsequently 3 cycles of platinum-based chemotherapy. Intention of surgery for both groups will be complete tumor resection as per guideline recommendations. Health related QoL will be assessed using the EORTC QLQ‐C30, QLQ‐OV28, and EQ‐5D‐3L questionnaires. For sample size planning, we considered a prolongation of median OS from 45 months in the IDS arm to 60 months in the PDS arm (HR 0.75) as clinically relevant. 380 events are needed to obtain a power of 80% in two‐sided log-rank test with significance level of 0.05. The primary analysis will be done in the ITT‐population of 686 randomized pts. By Feb 3 2017, 46 pts were randomized. Clinical trial information: NCT02828618.

Prognostic Value of Residual Tumor Size in Patients With Epithelial Ovarian Cancer FIGO Stages IIA–IV: Analysis of the OVCAD Data

2012 ◽  
Vol 22 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Stephan Polterauer ◽  
Ignace Vergote ◽  
Nicole Concin ◽  
Ioana Braicu ◽  
Radoslav Chekerov ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Tumor Size ◽  
Residual Disease ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Residual Tumor Size ◽  
Complete Tumor

ObjectiveThe objective of the study was to evaluate the prognostic impact of residual tumor size after cytoreductive surgery in patients with epithelial ovarian cancer.MethodsIn this prospective, multicenter study, 226 patients with epithelial ovarian cancer (International Federation of Gynecology and Obstetrics stages IIA–IV) were included. Patients were treated with cytoreductive surgery and adjuvant platinum-based chemotherapy. Univariate and multivariable survival analyses were performed to investigate the impact of residual tumor size on progression-free and overall survival.ResultsIn 69.4% of patients, surgery resulted in complete tumor resection; minimal residual disease (≤1 cm) was achieved in 87.2% of patients. Advanced tumor stage was associated with a lower rate of complete tumor resection (P < 0.001). After cytoreductive surgery, 3-year overall survival rates were 72.4%, 65.8%, and 45.2% for patients without, with minimal, and with gross residual disease (>1 cm), respectively (P < 0.001). Multivariable survival analysis revealed residual tumor size (P = 0.04) and older patient age (P = 0.02) as independent prognosticators for impaired overall survival. Complete cytoreduction was predictive for a higher rate of treatment response (P = 0.001) and was associated with prolonged progression-free and overall survival (P < 0.001 and P = 0.001).ConclusionsThe size of residual disease after cytoreduction is one of the most crucial prognostic factors for patients with ovarian cancer. Patients after complete cytoreduction have a superior outcome compared with patients with residual disease. Leaving no residual tumor has to be the aim of primary surgery for ovarian cancer; therefore, patients should receive treatment at centers able to undertake complex cytoreductive procedures.

Total retroperitoneal en bloc resection of multivisceral-peritoneal packet (TROMP operation): a novel surgical technique for advanced ovarian cancer

2020 ◽  
Vol 30 (5) ◽  
pp. 648-653 ◽  
Author(s):  
Mustafa Zelal Muallem ◽  
Jalid Sehouli ◽  
Andrea Miranda ◽  
Rolf Richter ◽  
Jumana Muallem
Keyword(s):  
Ovarian Cancer ◽  
Tumor Resection ◽  
Advanced Ovarian Cancer ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
Conventional Surgery ◽  
Complete Tumor Resection ◽  
En Bloc ◽  
Complete Tumor

BackgroundA Total Retroperitoneal en bloc resection Of Multivisceral-Peritoneal packet (TROMP operation) is a no-touch isolation technique in a retroperitoneal space to resect the parietal peritoneum and the affected organs in advanced ovarian cancer. The study prescribed and analysed the results of this novel technique for primary cytoreductive surgery.MethodsThe study included 208 patients operated between January 2015 and December 2017 in Charité, Berlin. The TROMP operation was performed in 58 patients, whereas the other 150 patients were operated with the conventional cytoreductive method.ResultsThe complete tumor resection rate accounts for 87.9% in TROMP group and 61.3% in the conventional surgery group. (p=0.001). This difference was even stronger in the sub-group of very advanced stages (T3c+T4) (85.1% of TROMP group and in only 53.1% in the conventional surgery group, p=0.001). The duration of the primary cytoreductive surgery was about 33 minutes shorter in TROMP group (median: 335 minutes vs 368 minutes; TROMP vs conventional, respectively) in spite of the fact that the most advanced cytoreductive procedures were performed statically significant more in TROMP operation arm in comparison with the conventional surgery arm. There was no statistically significant difference between the groups regarding the postoperative complication, blood loss or the length of stay in intensive care unit.ConclusionTotal retroperitoneal en bloc resection of multivisceral-peritoneal packet (TROMP operation) is a feasible and very effective technique of surgical therapy in advanced ovarian cancer. This technique increased the complete tumor resection rate to 87.9% without increasing the blood loss, postoperative complications or the duration of surgery. A prospective randomized study is advised to validate these results.

Osteosarcoma of the jaws: a literature review

2020 ◽  
Vol 16 ◽  
Author(s):  
Francesco Ricotta ◽  
Massimo Bassi ◽  
Nicola Tomasetti ◽  
Angelo Campobassi ◽  
Vincenzo Maiolo ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
State Of The Art ◽  
Bone Erosion ◽  
Tumor Resection ◽  
Bone Destruction ◽  
Cell Type ◽  
Complete Tumor Resection ◽  
Predominant Cell Type ◽  
Bone Changes ◽  
Complete Tumor

: Osteosarcoma of the jaws (OSJ) is a relatively rare disease, accounting for between 2% and 10% of all cases of osteosarcoma, it is morphologically and radiologically identical to the trunk and extremity variant, but distinct in several crucial aspects. : The lesion is characterized by sarcomatous cells which produces a variable amount of osteoid bone. It arises centrally within the bone and can be subdivided into osteoblastic, chondroblastic and fibroblastic subtype, depending on the predominant cell type. : Radiographically, these tumors display a spectrum of bone changes from well-demarcated borders to lytic bone destruction with indefinite margins and variable cortical bone erosion or, in some cases, images of sclerotic bone. Therapeutic options for OSJ include surgery, chemotherapy and radiotherapy, which are employed according to age of the patient, histological classification and localization of the tumor. Today there is no a general consensus in the treatment guidelines for the OSJ though surgery represents the key of the treatment. The main prognostic factor deeply influencing the patient's prognosis remains the complete tumor resection with negative surgical margins. : The aim of the present review is to describe the state of the art regarding diagnostic and surgical treatment aspects of the primary osteosarcoma of the jaws.

scholarly journals Management of a primary cardiac leiomyosarcoma in a young woman

2021 ◽  
Vol 29 (2) ◽  
pp. 267-270
Author(s):  
Mehmet Akif Önalan ◽  
Ahmet Demirkaya ◽  
Kemal Behzatoglu ◽  
Ersin Erek
Keyword(s):  
Pulmonary Veins ◽  
Tumor Resection ◽  
Complete Tumor Resection ◽  
The Right ◽  
Tumor Remnant ◽  
Invasive Techniques ◽  
Right Lower Lobectomy ◽  
Pathological Confirmation ◽  
Complete Tumor

Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.

Oncologic outcomes after secondary surgery in recurrent clear-cell carcinoma of the ovary

2019 ◽  
Vol 29 (5) ◽  
pp. 910-915 ◽  
Author(s):  
Hiroaki Kajiyama ◽  
Shiro Suzuki ◽  
Nobuhisa Yoshikawa ◽  
Michiyasu Kawai ◽  
Kiyosumi Shibata ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Cytoreductive Surgery ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Tumor Resection ◽  
Ovarian Clear Cell Carcinoma ◽  
Complete Tumor Resection ◽  
Secondary Cytoreductive Surgery ◽  
Disease Free ◽  
Complete Tumor

ObjectiveComplete tumor resection is considered essential in the management of patients with ovarian clear-cell carcinoma. There is a debate regarding whether patients with recurrent ovarian clear-cell carcinoma benefit from secondary cytoreductive surgery.MethodsDetails of patients with clear-cell carcinoma were collected by the Tokai Ovarian Tumor Study Group (Nagoya University Hospital and 13 affiliated institutions) and evaluated between January 1990 and December 2015. Histology was confirmed after central pathological review. The primary endpoint of the study was disease-free survival after secondary cytoreductive surgery. Distributions of events were evaluated using the χ2 test. Survival analysis was based on the Kaplan-Meier method. Survival curves were compared using the log-rank test. A value of p<0.05 was considered significant.ResultsA total of 169 patients who underwent secondary cytoreductive surgery (N=25) or medical management (N=144) for recurrent clear-cell carcinoma were collected. The median age for patients undergoing secondary cytoreductive surgery was 50 years (range 35–66). Overall, 18 patients had complete resection. In patients who underwent secondary cytoreductive surgery, the median disease-free and post-recurrence survival periods were 10.9 months and 21.2 months, respectively. Moreover, among 18 patients who underwent complete resection, seven showed no evidence of disease during the observation periods. The median post-recurrence survival periods of patients with complete or incomplete resection were 30.1 months and 10.4 months, respectively (p=0.002). On stratification by the recurrence site, patients with intraperitoneal recurrence showed poorer post-recurrence survival than those with recurrence at other sites (p=0.016). However, comparison between the secondary cytoreductive surgery group versus the medical management group showed there was no difference in post-recurrence survival, even when considering complete tumor resection (p=0.114).ConclusionPatients with intraperitoneal recurrence or incomplete tumor resection had the worst survival after secondary cytoreductive surgery.

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