Pattern of care study for treatment of ovarian cancer patients among Japanese gynecologists. A Japanese Gynecologic Oncology Group (JGOG) study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15029-15029
Author(s):  
K. Fujiwara ◽  
T. Sugiyama ◽  
E. Aotani ◽  
J. Kigawa ◽  
K. Kuzuya ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Gynecologic Oncology ◽  
Intestinal Resection ◽  
Advanced Ovarian Cancer ◽  
Cancer Center ◽  
Base Line ◽  
Gynecologic Oncology Group ◽  
Pattern Of Care ◽  
Gynecologic Oncologist

15029 Background: The Japanese Society of Gynecologic Oncology started a training program for the subspecialty of board certified gynecologic oncologists in 2005. This study aimed to assess the attitude of Japanese gynecologists for the treatment of ovarian cancer in pre-gynecologic oncologist era. Methods: The JGOG distributed a survey to 217 member institutions in January 2005. The principal investigator (PI) of each institution answered 33 questionnaires regarding diagnostic, surgical and chemotherapy issues. The survey was returned from 156 institutions (71.9%). Results: Hospital settings were general (44%), academic (44%), Cancer Center (8%), or private (4%). Only two of PIs were medical oncologists and rests of them were gynecologists. As the staging procedure in early ovarian cancer, 67% institutions do systemic pelvic lymphadenectomy (LNX) but 22% do only sampling. For the paraaortic nodes, 36% do systemic LNX and 10% do sampling below renal vein, and 14% do LNX and 12% do sampling below inferior mesenteric artery. However, intraabdominal explorations such as multiple peritoneal biopsies have been done only less than 30% except for omentectomy (90%). With regard to the surgery for advanced ovarian cancer, 57% institutions do not do any intestinal resection and anastomosis during the primary surgery. Among them 7% of institutions prefer neoadjuvant chemotherapy (no debulking at all) for advanced ovarian cancer. However, 84% of the institutions do interval debulking and 57% of them are quite aggressive for the procedure. These results demonstrate the high expectation that chemotherapy may reduce the aggressiveness of surgery for advanced ovarian cancer. In terms of chemotherapy for the high-risk early and advanced ovarian cancer, taxane plus platinum is the most used regimen (93–95%). However, 45% of institutions prefer different regimen for clear cell carcinoma. CPT-11 is the most used (88.6%). Intraperitoneal chemotherapy has been performed in 28.2% of institutions. 37.2% of institutions do consolidation chemotherapy. Conclusions: This is an important base-line information to assess the pattern of care for ovarian cancer patients in the era before gynecologic oncologist subspecialty is applicable in Japan. No significant financial relationships to disclose.

The Sandwich Technique of Diaphragmatic Stripping or Full-Thickness Resection for Advanced Ovarian Cancer: How to Keep it Short and Simple

2015 ◽  
Vol 25 (1) ◽  
pp. 131-134 ◽  
Author(s):  
Christoph Grimm ◽  
Philipp Harter ◽  
Florian Heitz ◽  
Andreas du Bois
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Gynecologic Oncology ◽  
Advanced Ovarian Cancer ◽  
Residual Tumor ◽  
Recent Analysis ◽  
Gynecologic Oncology Group ◽  
Anatomical Landmarks ◽  
Full Thickness ◽  
Sandwich Technique

ObjectiveResidual tumor is an important prognostic factor in advanced ovarian cancer patients. A recent analysis from a large Gynecologic Oncology Group trial identified the diaphragm as the most common localization for residual tumor after surgery in advanced ovarian cancer. This stresses the need for more knowledge and training in diaphragmatic surgery in patients with advanced ovarian cancer.Methods/MaterialsWe aimed to describe a safe structured technique to perform transection of the peritoneal diaphragm or full-thickness resection of the diaphragm.ResultsThe structured technique consists of 5 steps as follows: (1) knowledge of anatomical landmarks, (2) adequate exposure of the surgical field, (3) mobilization of the liver, (4) demarcation of the resection lines of the peritoneum, and (5) mobilization of the diaphragmatic peritoneum by using the sandwich technique or performance of a full-thickness resection with subsequent suture.ConclusionsDiaphragmatic surgery is an important part of upper abdominal surgery in advanced ovarian cancer patients. It is a safe structured procedure, which should be routinely performed to achieve optimal surgical results for these patients.

Analysis of the cost-effectiveness of paclitaxel as alternative combination therapy for advanced ovarian cancer.

1997 ◽  
Vol 15 (2) ◽  
pp. 640-645 ◽  
Author(s):  
W McGuire ◽  
A I Neugut ◽  
S Arikian ◽  
J Doyle ◽  
C M Dezii
Keyword(s):  
Ovarian Cancer ◽  
Survival Time ◽  
Pharmacoeconomic Analysis ◽  
Gynecologic Oncology ◽  
Alternative Therapy ◽  
Advanced Ovarian Cancer ◽  
Cost Effective ◽  
Phase Iii ◽  
Gynecologic Oncology Group ◽  
Kaplan Meier

PURPOSE A phase III trial by the Gynecologic Oncology Group (GOG) provides strong evidence that a new alternative therapy--paclitaxel (Taxol; Bristol-Myers Squibb Co, Princeton, NJ) in combination with cisplatin (Platinol; Bristol-Myers Squibb Co)--is clinically more effective than the standard therapy using cyclophosphamide (Cytoxan; Bristol-Myers Squibb Co) in combination with cisplatin in the treatment of advanced ovarian cancer. We conducted a pharmacoeconomic analysis to determine whether the alternative paclitaxel-cisplatin (TP) therapy is cost-effective (CE) in comparison to standard cyclophosphamide-cisplatin (CP) therapy. METHODS Using an economic model, we applied cost data figures to resource utilization data derived from the two arms of the GOG trial. We examined paclitaxel benefits in terms of increased mean survival time, as well as median survival time. Estimates of the cumulative proportion surviving in the trial were based on Kaplan-Meier procedures. RESULTS Per year of life gained (YLG), TP therapy costs more ($19,820 more for inpatient treatment; $21,222 outpatient) than CP treatment. CONCLUSION The TP regimen's increased mean survival cost per YLG (inpatient and outpatient settings) adds a substantial benefit at an acceptable cost compared with CP therapy.

The evaluation of intra- and postoperative complications related to debulking surgery with bowel resection in patients with FIGO stage III–IV ovarian cancer

2007 ◽  
Vol 17 (5) ◽  
pp. 993-997 ◽  
Author(s):  
M. Bidzinski ◽  
P. Derlatka ◽  
P. Kubik ◽  
I. Ziolkowska-Seta ◽  
A. Dańska-Bidzinska ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Hartmann’S Procedure ◽  
Debulking Surgery ◽  
Hartmann's Procedure

The surgical treatment of advanced ovarian cancer is based on the maximal debulking with widening the operation range to the infiltrated organs. The aims are as follows: (1) the assessment of the quantity and quality of intra- and postoperative complications in patients with advanced ovarian cancer in which partial bowel resection was performed and (2) the evaluation of intra- and postoperative complications related to surgery with bowel resection and anastomosis, compared to Hartmann's procedure. The analysis of debulking procedures with intestinal resection and postoperative period in 39 ovarian cancer patients, FIGO stage III–IV, was performed. During 39 operations, the most frequent type of resection was the sigmoidectomy or proctosigmoidectomy (29 patients). In the remaining patients, left- and right-side hemicolectomy or partial enterectomy was done. Twenty-four anastomosis and 15 Hartmann's procedures were performed. There were no differences between surgery with anastomosis and Hartmann's procedure in aspect of quantity of complications, blood loss, and the time of surgery. There were no statistically significant differences in overall survival and progression-free survival in both groups. We conclude that the percentage of complications related to debulking surgery with intestinal resection in advanced ovarian cancer patients might be accepted. The quantity of complications related to surgery with anastomosis and to Hartmann's procedure is similar. If possible, the surgery with anastomosis should be performed.

scholarly journals Clinical pathways of recovery after surgery for advanced ovarian/tubal/peritoneal cancer: an NSGO-MaNGO international survey in collaboration with AGO—a focus on surgical aspects

2019 ◽  
Vol 29 (1) ◽  
pp. 181-187 ◽  
Author(s):  
Elisa Piovano ◽  
Annamaria Ferrero ◽  
Paolo Zola ◽  
Christian Marth ◽  
Mansoor Raza Mirza ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Enhanced Recovery ◽  
Clinical Pathways ◽  
Gynecologic Oncology ◽  
Advanced Ovarian Cancer ◽  
Standard Of Care ◽  
Study Groups ◽  
Gynecologic Oncology Group ◽  
Peritoneal Cancer ◽  
Peritoneal Drainage

ObjectivesThis survey assessed the implementation of enhanced recovery after surgery (ERAS) for patients undergoing surgery for advanced ovarian cancer in three European cooperative study groups in Scandinavia, Italy, and Austria. The aim was to evaluate the landscape for future trials on ERAS pathways in ovarian cancer, because high-level evidence for such interventions is lacking.MethodsIn July 2017, a web-based questionnaire (SurveyMonkey Inc, Palo Alto, CA, USA) was sent to centers conducting surgery for advanced ovarian cancer within the Nordic Society of Gynecologic Oncology (NSGO), Mario Negri Gynecologic Oncology Group (MaNGO) and other Italian institutions, and the Association for Gynecologic Oncology Austria (AGO Austria) (n = 100). The survey covered all aspects of an ERAS pathway including surgery, nursing, and anesthesia. We herein report on the survey findings relating to surgery, including nursing care issues; however, anesthesiologic issues will be discussed in a separate report.ResultsThe overall response rate was 62%. Only a third of the centers in Italy and Austria follow a written ERAS protocol compared with 60% of the Scandinavian centers. Only a minority of centers have completely abandoned bowel preparation, with the highest proportion in Scandinavia (36%). Two hours of fasting for fluids before surgery is routinely practiced in Scandinavia and Austria (67–57%, respectively), but not in Italy (5%). Carbohydrate loading is routinely administered only in Scandinavia (67%). Peritoneal drainage is used by 22% routinely and by 61% in cases of bowel resection/lymphadenectomy/peritonectomy. Early feeding with a light diet on day 0 or 1 is the standard of care in Scandinavia and Austria, but not in Italy.ConclusionsThe degree of implementation of ERAS protocols varies across and within cooperative groups. The centralization of ovarian cancer care seems to facilitate standardization of peri-operative protocols. Currently, the high heterogeneity in patterns of care may challenge an international approach to a clinical trial.

Sign in / Sign up

Export Citation Format

Share Document