scholarly journals Efficacy Evaluation Of Albumin-Bound Paclitaxel Combined With Carboplatin As Neoadjuvant Chemotherapy For Primary Epithelial Ovarian Cancer

2020 ◽  
Author(s):  
Huan Wang ◽  
Yimin Han
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Operation Time ◽  
Efficacy Evaluation ◽  
Total Incidence ◽  
Total Hospital Stay ◽  
Therapeutic Value ◽  
Primary Epithelial Ovarian Cancer ◽  
Medical University

Abstract Background: This study aimed to compare the efficacy of albumin-bound paclitaxel combined with carboplatin (Nab-TC) with that of traditional solvent-based paclitaxel combined with carboplatin (TC) as a neoadjuvant chemotherapy regimen for primary epithelial ovarian cancer. Methods: Seventy-six patients with advanced primary epithelial ovarian cancer admitted for treatment at the Third Affiliated Hospital of Harbin Medical University from January 2015 to August 2020 were retrospectively selected. All patients underwent surgery after two courses of neoadjuvant chemotherapy with a combination of paclitaxel and carboplatin. Among the patients included for study, 34 were in the Nab-TC program and 42 in the TC program. Results: After two courses of chemotherapy, the ORR value was 52.38% in the TC group and 58.82% in the Nab-TC group (P=0.355). The CA125 value of the Nab-TC group decreased by 88.28% and that of the TC group by 86.99% (P=0.358). Overall operation time, intraoperative blood loss and postoperative hospital time of patients in the Nab-TC group were lower (P>0.05) and length of total hospital stay was significantly lower (P<0.05) relative to the TC group. Moreover, incidence of bone marrow suppression, abnormal liver function, arrhythmia and hyperglycemia in the Nab-TC group were lower (P>0.05) and total incidence of nausea and vomiting as well as grade III and IV stages were significantly lower (P<0. 05) than those in the TC group. However, the frequency of acral numbness in Nab-TC group was higher compared to the TC group (P<0.05). Conclusion: The efficacy of the Nab-TC regimen as neoadjuvant chemotherapy for advanced primary epithelial ovarian cancer was equivalent to that of the TC regimen, along with a lower incidence of adverse reactions, supporting its therapeutic value in the clinic.

scholarly journals Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data

2021 ◽  
Vol 10 (2) ◽  
pp. 334
Author(s):  
Stephanie Seidler ◽  
Meriem Koual ◽  
Guillaume Achen ◽  
Enrica Bentivegna ◽  
Laure Fournier ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Lymph Node Dissection ◽  
Prospective Trial ◽  
Node Dissection ◽  
Advanced Epithelial Ovarian Cancer ◽  
The Impact ◽  
Systematic Lymph Node Dissection

Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in the setting of primary surgical treatment. Evidence supporting the same postulate for patients undergoing complete cytoreductive surgery after neoadjuvant chemotherapy (NACT) is lacking. Throughout a systematic literature review, the aim of our study was to evaluate the impact of lymph node dissection in patients undergoing surgery for advanced-stage EOC after NACT. A total of 1094 patients, included in six retrospective series, underwent either systematic, selective or no lymph node dissection. Only one study reveals a positive effect of lymphadenectomy on OS, and two on RFS. The four remaining series fail to demonstrate any beneficial effect on survival, neither for RFS nor OS. All of them highlight the higher peri- and post-operative complication rate associated with systematic lymph node dissection. Despite heterogeneity in the design of the studies included, there seems to be a trend showing no improvement on OS for systematic lymph node dissection in node negative patients. A well-conducted prospective trial is mandatory to evaluate this matter.

Incidence of venous thromboembolism among patients receiving neoadjuvant chemotherapy for advanced epithelial ovarian cancer

2020 ◽  
Vol 30 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Julia Rose Salinaro ◽  
Kourtnie McQuillen ◽  
Megan Stemple ◽  
Robert Boccaccio ◽  
Jessie Ehrisman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Adjuvant Chemotherapy ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Primary Outcome ◽  
Vein Thrombosis ◽  
Deep Vein

ObjectivesNeoadjuvant chemotherapy may be considered for women with epithelial ovarian cancer who have poor performance status or a disease burden not amenable to primary cytoreductive surgery. Overlap exists between indications for neoadjuvant chemotherapy and known risk factors for venous thromboembolism, including impaired mobility, increasing age, and advanced malignancy. The objective of this study was to determine the rate of venous thromboembolism among women receiving neoadjuvant chemotherapy for epithelial ovarian cancer.MethodsA multi-institutional, observational study of patients receiving neoadjuvant chemotherapy for primary epithelial ovarian, fallopian tube, or peritoneal cancer was conducted. Primary outcome was rate of venous thromboembolism during neoadjuvant chemotherapy. Secondary outcomes included rates of venous thromboembolism at other stages of treatment (diagnosis, following interval debulking surgery, during adjuvant chemotherapy, or during treatment for recurrence) and associations between occurrence of venous thromboembolism during neoadjuvant chemotherapy, subject characteristics, and interval debulking outcomes. Venous thromboembolism was defined as deep vein thrombosis in the upper or lower extremities or in association with peripherally inserted central catheters or ports, pulmonary embolism, or concurrent deep vein thrombosis and pulmonary embolism. Both symptomatic and asymptomatic venous thromboembolism were reported.ResultsA total of 230 patients receiving neoadjuvant chemotherapy were included; 63 (27%) patients overall experienced a venous thromboembolism. The primary outcome of venous thromboembolism during neoadjuvant chemotherapy occurred in 16 (7.7%) patients. Of the remaining venous thromboembolism events, 22 were at diagnosis (9.6%), six post-operatively (3%), five during adjuvant chemotherapy (3%), and 14 during treatment for recurrence (12%). Patients experiencing a venous thromboembolism during neoadjuvant chemotherapy had a longer mean time to interval debulking and were less likely to undergo optimal cytoreduction (50% vs 80.2%, p=0.02).ConclusionsPatients with advanced ovarian cancer are at high risk for venous thromboembolism while receiving neoadjuvant chemotherapy. Consideration of thromboprophylaxis may be warranted.

Central Nervous System Metastases from Primary Epithelial Ovarian Cancer

2003 ◽  
Vol 10 (3) ◽  
pp. 244-253 ◽  
Author(s):  
Lalit Kumar ◽  
Suchitra Barge ◽  
Ashok K. Mahapatra ◽  
Sanjay Thulkar ◽  
Gaura Kishore Rath ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Central Nervous System ◽  
Nervous System ◽  
Epithelial Ovarian Cancer ◽  
Central Nervous System Metastases ◽  
Primary Epithelial Ovarian Cancer

scholarly journals The FIGO Stage IVA Versus IVB of Ovarian Cancer: Prognostic Value and Predictive Value for Neoadjuvant Chemotherapy

2018 ◽  
Vol 28 (3) ◽  
pp. 453-458 ◽  
Author(s):  
Parvin Tajik ◽  
Roelien van de Vrie ◽  
Mohammad H. Zafarmand ◽  
Corneel Coens ◽  
Marrije R. Buist ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Prognostic Value ◽  
Median Overall Survival ◽  
Stage Iv ◽  
Figo Stage ◽  
Figo Staging ◽  
Stage Ivb

ObjectiveThe revised version of the International Federation of Gynaecology and Obstetrics (FIGO) staging system (2014) for epithelial ovarian cancer includes a number of changes. One of these is the division of stage IV into 2 subgroups. Data on the prognostic and predictive significance of this classification are scarce. The effect of neoadjuvant chemotherapy (NACT) versus primary debulking surgery (PDS) in relation to the subclassification of FIGO stage IV is also unknown.MethodsWe used data of the EORTC 55971 trial, in which 670 patients with previous stage IIIC or IV epithelial ovarian cancer were randomly assigned to PDS or NACT; 160 patients had previous stage IV. Information on previous FIGO staging and presence of pleural effusion with positive cytology were used to classify tumors as either stage IVA or IVB. We tested the association between stage IVA/IVB and survival to evaluate the prognostic value and interactions between stage, treatment, and survival to evaluate the predictive performance.ResultsAmong the 160 participants with previous stage IV disease, 103 (64%) were categorized as stage IVA and 57 (36%) as stage IVB tumors. Median overall survival was 24 months in FIGO stage IVA and 31 months in stage IVB patients (P = 0.044). Stage IVB patients treated with NACT had 9 months longer median overall survival compared with IVB patients undergoing PDS (P = 0.025), whereas in IVA patients, no significant difference was observed (24 vs 26 months, P = 0.48).ConclusionsThe reclassification of FIGO stage IV into stage IVA or IVB was not prognostic as expected. Compared with stage IVA patients, stage IVB patients have a better overall survival and may benefit more from NACT.

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