scholarly journals RETROSPECTIVE ANALYSIS OF LONG-TERM SURVIVAL OUTCOMES OF PRIMARY CYTOREDUCTION AND NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH OVARIAN CANCER STAGE IIIC–IV

2018 ◽  
Vol 8 (3) ◽  
pp. 86-94 ◽  
Author(s):  
A. S. Tjulandina ◽  
A. A. Rumyantsev ◽  
K. Y. Morkhov ◽  
V. M. Nechushkina ◽  
S. A. Tjulandin
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Retrospective Analysis ◽  
Low Frequency ◽  
Progression Free Survival ◽  
Long Term Results ◽  
Survival Outcomes ◽  
Stage Iiic ◽  
Term Survival

The choice of treatment strategy in patients with stage IIIC‑IV ovarian cancer (OC) remains the subject of numerous discussions. The reason for this is the unsatisfactory results of randomized trials and the low frequency of primary complete debulking surgery in these studies. We conducted a retrospective analysis to evaluate the survival outcomes in patients with OC stage IIIC–IV (n=314) who underwent treatment between 1995 and 2017. The median progression free survival for primary surgery was 15.6 months, after interval debulking – 11.5 months (p=0.002, HR 0.61: 95 % CI 0.39–0.81). The primary cytoreduction significantly increased the median of overall survival by 19.6 months: from 38.0 months after interval debulking up to 57.6 months after primary cytoreduction (p=0.04, HR 0.64: 95 % CI 0.41–0.99). An increase in the number of optimal interval debulking does not lead to an improvement in the long-term results of treatment in the group of patients after neoadjuvant chemotherapy. Our analysis over the past 20 years has shown that improvement in treatment outcomes is only observed in the primary cytoreduction group due to an increase in the number of complete optimal cytoreductive surgery.

Does neoadjuvant chemotherapy impair long-term survival for ovarian cancer patients? A nationwide Danish study

2014 ◽  
Vol 132 (2) ◽  
pp. 292-298 ◽  
Author(s):  
Carsten Lindberg Fagö-Olsen ◽  
Bent Ottesen ◽  
Henrik Kehlet ◽  
Sofie L. Antonsen ◽  
Ib J. Christensen ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Danish Study

A retrospective analysis of neoadjuvant platinum-based chemotherapy versus up-front surgery in advanced ovarian cancer

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 47-53 ◽  
Author(s):  
H. Steed ◽  
A. M. Oza ◽  
J. Murphy ◽  
S. Laframboise ◽  
G. Lockwood ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Retrospective Analysis ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Postoperative Chemotherapy ◽  
Pleural Effusions ◽  
Primary Surgery ◽  
Platinum Based Chemotherapy ◽  
Significant Difference

The objective of this study is to compare progression-free survival (PFS) and overall survival (OS) of ovarian cancer patients treated with neoadjuvant chemotherapy and surgery to primary surgery and postoperative chemotherapy. Retrospective analysis from 1998 to 2003 of 116 patients with ovarian cancer was performed. Fifty women diagnosed by positive cytology received three cycles of carboplatin and paclitaxel. Thirty-six patients subsequently underwent cytoreductive surgery and completed three further cycles postoperatively. The OS and PFS were compared in 66 women treated with primary surgery and postoperative chemotherapy. A statistically significant difference was observed for OS (P= 0.03, HR = 1.85, CI = 1.06–3.23) and PFS (P= 0.04, HR = 1.61, CI = 1.03–2.53) favoring the primary surgery group. Due to the small numbers, age, grade, stage, pleural effusions, and histologic cell type were controlled for separately in the bivariate analyses. Controlling for stage made the results weaker. A matched subgroup survival analysis was performed on patients who had surgery following neoadjuvant chemotherapy. After matching for stage and grade and controlling age and pleural effusions (N= 28 matched pairs), there was no statistical difference for OS (P= 0.95, HR = 1.04, CI = 0.33–3.30) or PFS (P= 0.79, HR = 1.11, CI = 0.98–1.04). It is concluded that primary surgery should be considered in all patients. Neoadjuvant chemotherapy may be an alternative in a subset of women with the intent to also perform interval debulking.

CYTOREDUCTIVE SURGERY FOR OVARIAN CANCER: A REVIEW OF LITERATURE AND ANALYSIS OF THE EXPERIENCE OF THE CLINIC FOR THIRTEEN YEARS

2018 ◽  
Vol 64 (3) ◽  
pp. 353-365
Author(s):  
Tatyana Gorodnova ◽  
Nikolay Bondarev ◽  
Olga Lavrinovich ◽  
Nikolay Mikaya ◽  
Yelena Ulrikh ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Life Expectancy ◽  
Cytoreductive Surgery ◽  
Postoperative Chemotherapy ◽  
Long Term Results ◽  
Chemotherapy Group ◽  
Results Of Treatment ◽  
Free Interval

The article presents the world experience of cytoreductive surgery for ovarian cancer (OC) according to literature data and also estimates the thirteen-year experience of the Oncogynecology Department of the N.N. Petrov National Medical Research Center of Oncology in the treatment of OC patients. Materials and methods: In order to analyze the results of treatment for thirteen years it is proposed a comparative evaluation of results of primary and interval cytoreductive operations in 213 patients with OC. For this purpose all patients depending on the start of treatment were divided into two groups: a group of patients with an advanced OC where treatment started with neoadjuvant chemotherapy and a group of patients with an advanced OC where primary cytoreductive surgery was performed at the start of treatment. In these groups the long-term results of treatment were studied: platinum-free interval and life expectancy. Results: When studying the effect of a number of neoadjuvant chemotherapy courses on long-term results of treatment it was established that the best results for platinum-free interval were obtained in a 3-course group of neoadjuvant chemotherapy - platinum-free interval was 9.6 months compared to 6.9 and 4.7 months in groups of 4 and> 5 courses although the differences in the groups did not reach statistically significant rates (p = 0.337). The increase in a number of postoperative chemotherapy courses in our study also statistically was unreliable and had a negative effect on survival: patients from the neoadjuvant chemotherapy group with> 3 courses of postoperative chemotherapy had 9.6 months versus 11.7 months in patients with 3 courses p = 0.787); life expectancy was 35.6 months compared to 30.9 months respectively (p = 0.968). The same tendency was also observed in patients from the primary cytoreduction group: in the group of patients with> 3 courses of postoperative chemotherapy platinum-free interval was 10.2 months compared to 16.3 months in patients with 3 courses (p = 0.312); life expectancy was 54.4 months compared with 48.7 months respectively (p = 0.435). The Kaplan-Meier survival estimation revealed a statistically significant improvement in life expectancy index for patients from the primary cytore-duction group (median survival time 53.7 months, 95 % CI 41.9-73.6 months) compared to patients in the neoadjuvant chemotherapy group (median life expectancy 33.0 months, 95 % CI 20.6-42.0 months, p <0.000001).

Impact of BRCA mutation status and time to platinum resistance on patients with advanced ovarian cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5561-5561
Author(s):  
Alexandra Tyulyandina ◽  
Maxim Filipenko ◽  
Alexey Rumyantsev ◽  
Ilya Pokataev ◽  
Valentina Nechushkina ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Brca Mutation ◽  
Advanced Ovarian Cancer ◽  
Progression Free Survival ◽  
Platinum Resistance ◽  
Term Survival ◽  
Mutation Status ◽  
Platinum Based Chemotherapy ◽  
Significant Difference

5561 Background: The influence of germline BRCA1/2 mutations (gBRCAmt) on ovarian cancer patients (pts) long-term survival remains controversial. Methods: 228 pts with serous and endometrial ovarian cancer stage Ic-IV were enrolled in the retrospective study. Next-generation sequencing testing of BRCA1/2 in blood was employed. Progression-free survival (PFS), overall survival (OS) and time to platinum resistance (TPR) were analyzed. TPR was defined as time from first line chemotherapy to registration of platinum resistance relapse. Results: The rate of pathogenic gBRCAmt was defined in 29.4% (67/228) pts. There was no any significant difference between BRCA1/2 mutation carries and non-carries in both PFS (18.3 and 16.7 months, p = 0.27, HR 0.79, 95%CI 0.52-1.20) and OS (71.9 and 79.1 months, p = 0.69, HR 0.88, 95%CI 0.46-1.68). However, TPR was significantly longer in pts with gBRCAmt than in germline BRCA wild type (gBRCAwt) pts (51.4 and 34.4 months, p = 0.05, HR 0.60, 95% CI 0.36-0.98). Pts with gBRCAmt had poor prognosis after registration of platinum resistance. gBRCAwt pts had longer survival than gBRCAmt after platinum-resistance relapse: 33.7 and 16.9 months respectively (p = 0.05; HR 1.85, 95%CI 1.02-4.08). Conclusions: Our finding provided possible explanation of equal survival of pts with or without BRCA1/2 mutations. Long-term sensitivity to platinum-based chemotherapy allowed pts with gBRCA1/2mt to control the disease for a long period of time. However the non-platinum regimens had less efficacy in pts with gBRCAmt than gBRCAwt after platinum resistance.

Long-Term Survival and Cost of Treatment in Patients with Stage IIIC Epithelial Ovarian Cancer

2009 ◽  
Vol 5 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Leniaud Louis ◽  
Sifer Christophe ◽  
Amy Cooper ◽  
David Nelson ◽  
Stacy Doran ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Stage Iiic ◽  
Cost Of Treatment ◽  
Term Survival ◽  
Long Term Survival

Long term survival outcomes of stage I mucinous ovarian cancer - A clinical calculator predictive of chemotherapy benefit

2020 ◽  
Vol 159 (1) ◽  
pp. 118-128
Author(s):  
Michael T. Richardson ◽  
David P. Mysona ◽  
David A. Klein ◽  
Amandeep Mann ◽  
Cheng-I Liao ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Stage I ◽  
Survival Outcomes ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Evaluating the benefits of neoadjuvant chemotherapy for advanced epithelial ovarian cancer: a retrospective study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Yan Gao ◽  
Yuan Li ◽  
Chunyu Zhang ◽  
Jinsong Han ◽  
Huamao Liang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Survival Curve ◽  
Progression Free Survival ◽  
Debulking Surgery ◽  
Stage Iiic ◽  
Free Survival ◽  
Primary Debulking Surgery ◽  
Interval Debulking Surgery

Abstract Objective To compare the chemoresistance and survival in patients with stage IIIC or IV epithelial ovarian cancer who were treated with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) or primary debulking surgery (PDS). The clinical characteristics of patients who benefited from NACT were further evaluated. Methods We retrospectively analyzed 220 patients who underwent NACT followed by IDS or PDS from January 2002 to December 2016. Differences in clinicopathological features, chemoresistance and prognosis were analyzed. Results The incidence rate for optimal cytoreduction and chemoresistance in the NACT group was relatively higher than PDS group. No differences were observed in progression free survival or overall survival. Patients without macroscopic RD in NACT group (NACT-R0) had a similar prognosis compared to those in PDS group who had RD<1 cm, and a relatively better prognosis compared to the PDS group that had RD ≥ 1 cm. The survival curve showed that patients in NACT-R0 group that were chemosensitive seemed to have a better prognosis compared to patients in PDS group that had RD. Conclusion Patients without RD after PDS had the best prognosis, whereas patients with RD after NACT followed by IDS had the worst. However, even if patients achieved no RD, their prognosis varied depending on chemosensitivity. Survival was better in patients who were chemosensitive compared to thosewho underwent PDS but had RD. Hence evaluating the chemosensitivity and feasibility of complete cytoreduction in advance is crucial.

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