Faculty Opinions recommendation of Patterns of recurrence and clinical outcome of patients with stage IIIC to stage IV epithelial ovarian cancer in complete response after primary debulking surgery plus chemotherapy or neoadjuvant chemotherapy followed by interval debulking surgery: an italian multicenter retrospective study.

2017 ◽  
Author(s):  
Katherine Fuh
Keyword(s):  
Ovarian Cancer ◽  
Retrospective Study ◽  
Neoadjuvant Chemotherapy ◽  
Stage Iv ◽  
Complete Response ◽  
Debulking Surgery ◽  
Stage Iiic ◽  
Primary Debulking Surgery ◽  
Interval Debulking Surgery ◽  
Patterns Of Recurrence

Patterns of Recurrence and Clinical Outcome of Patients With Stage IIIC to Stage IV Epithelial Ovarian Cancer in Complete Response After Primary Debulking Surgery Plus Chemotherapy or Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery: An Italian Multicenter Retrospective Study

2016 ◽  
Vol 27 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Angiolo Gadducci ◽  
Stefania Cosio ◽  
Valentina Zizioli ◽  
Sara Notaro ◽  
Roberta Tana ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Retrospective Study ◽  
Neoadjuvant Chemotherapy ◽  
Clinical Outcome ◽  
Epithelial Ovarian Cancer ◽  
Recurrence Rate ◽  
Complete Response ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Interval Debulking Surgery

ObjectiveThe objective of this retrospective study was to assess the clinical outcome of patients with advanced epithelial ovarian cancer in complete response after primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (IDS]).MethodsThe authors reviewed the hospital records of 384 patients who underwent PDS (n = 322) or IDS (n = 62) and who were in complete response after primary treatment.ResultsOptimal (residual disease [RD] < 1 cm) and complete (no gross RD) cytoreduction rates were higher after IDS than after PDS (71.0% vs 55.9%;P= 0.001 and 51.6% vs 35.7%, respectively;P= 0.02). Tumor recurred in 73.0% of the 322 complete responders after PDS versus 87.1% of the 62 complete responders after IDS (P= 0.01). The IDS group showed a higher recurrence rate within 6 months (11.3% vs 3.1%:P= 0.01) and a trend to higher recurrence rate between 6 and 12 months (30.6% vs 19.9%). Tumor recurred in 57.4% of the 115 completely cytoreduced patients after PDS versus 87.5% of the 32 completely cytoreduced patients after IDS (P= 0.001). The IDS group showed a trend to higher recurrence rate within 6 months (6.2% vs 1.7%) and a higher recurrence rate between 6 and 12 months (37.5% vs 15.6%;P= 0.01). Two-year, 5-year, and 7-year progression-free survival were 65.8%, 40.8%, and 39.3% for completely cytoreduced patients after PDS versus 43.8%, 12.5%, and 12.5% for completely cytoreduced patients after IDS (P= 0.001); and 2-year, 5-year, and 7-year overall survival were 96.4%, 69.3%, and 50.4% for the former versus 87.1%, 41.8%, and 32.6% for the latter (P= 0.001).ConclusionsThe clinical outcome of completely cytoreduced patients was significantly better for PDS group than for IDS group, and therefore, the achievement of no gross RD after surgery seemed to have a different prognostic relevance for the 2 groups.

Neoadjuvant chemotherapy with six cycles of carboplatin and paclitaxel in advanced ovarian cancer patients not candidates for optimal primary surgery: Safety and effectivenes.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5540-5540
Author(s):  
Vanessa Costa Miranda ◽  
Angelo Bezerra de Sousa Fede ◽  
Carlos Henrique Dos Anjos ◽  
Juliana Ribeiro da Silva ◽  
Fernando Barbosa Sanchez ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Disease Progression ◽  
Advanced Ovarian Cancer ◽  
Length Of Hospital Stay ◽  
Complete Response ◽  
Debulking Surgery ◽  
Stage Iiic ◽  
Primary Debulking Surgery

5540 Background: Primary debulking surgery (PDS) has been considered the standard of treatment in advanced ovarian cancer, while neoadjuvant chemotherapy, three cycles followed by interval debulking (ID) surgery, is a valid treatment alternative for patients with non-resectable disease. This study aimed to show the efficacy and safety of six cycles of neoadjuvant chemotherapy (N-CT) followed by cytoreduction, a single institution experience. Methods: Aretrospective analysis was performed of all patients (pts) with advanced ovarian cancer treated with platinum based N-CT, between January/2004 and February/2012. Results: 97 pts underwent N-CT in our institution; 78.1% and 18.8% the patients had extensive stage IIIC or IV disease at diagnosis, respectively. Median age 60 years (36 – 82). Histologic types: serous 84.5%, adenocarcinoma not specified 11.3%, endometrioide 1.0%. A median of six cycles of chemotherapy were performed. Patients did not received chemotherapy after debulking surgery. During the treatment 31.4% had grade 3/4 toxicity, the most commonly observed toxicities were hematologic toxicities and nausea, four (4.1%) patients died during chemotherapy due to disease progression. After N-CT 24.7% achieved clinical complete response, 57.7% partial response and 12.4% disease progression. From this cohort 63.1% underwent a complete resection of all macroscopic and microscopic disease (R0). Median length of hospital stay and postoperative ICU stay was 5 and 0.8 days respectively, surgical complications were not common however five (7.1%) patients needed second surgery due to operatory complications and 19 pts (27.1%) needed blood transfusion after debulking. With a median follow up of 21.8 months (0.5-139.7), median overall survival and chemotherapy-free interval were 57,7 and 9,5 months, respectively. Conclusions: Six cycles of neoadjuvant carboplatin and paclitaxel is safe, effective and does not increase perioperative and postoperative complications for patients with stage IIIC-IV not candidates for optimal/R0 PDS. The overall survival of this cohort is higher than those treated with interval debulking surgery.

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.

Primary debulking surgery versus neoadjuvant chemotherapy in stage IV ovarian cancer

2011 ◽  
Vol 120 ◽  
pp. S12-S13 ◽  
Author(s):  
J. Rauh-Hain ◽  
W. Growdon ◽  
N. Rodriguez ◽  
A. Goodman ◽  
D. Boruta ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Stage Iv ◽  
Debulking Surgery ◽  
Primary Debulking Surgery

ATL

2018 ◽  
Vol 28 (8) ◽  
pp. 1498-1506 ◽  
Author(s):  
Tatyana V. Gorodnova ◽  
Khristina B. Kotiv ◽  
Alexandr O. Ivantsov ◽  
Olga N. Mikheyeva ◽  
Galina I. Mikhailiuk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Cells ◽  
Mitomycin C ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Tumor Burden ◽  
Debulking Surgery ◽  
Tumor Spread ◽  
Primary Debulking Surgery

ObjectivesCisplatin and mitomycin C exert high activity towards BRCA1-deficient cells. This study aimed to evaluate the efficacy of a combination of these drugs in hereditary BRCA1-associated ovarian cancer (OC).MethodsTwelve OC patients, who could not be treated by primary debulking surgery owing to extensive tumor spread, were given neoadjuvant cisplatin (100 mg/m2) and mitomycin C (10 mg/m2) every 4 weeks for 3 (n = 9), 2 (n = 2), or 4 (n = 1) cycles.ResultsThe decrease of tumor burden and complete surgical cytoreduction were achieved in all patients. Pathologic complete response, defined as the absence of tumor cells in surgically removed tissues, was observed in 2 (17%) of 12 cases. Retrospective analysis of 62 OC in BRCA1 mutation carriers subjected to conventional neoadjuvant chemotherapy schemes revealed 36 objective tumor responses (58%) and 37 instances (60%) of complete cytoreductive surgery; however, none of these patients demonstrated pathologic complete response.ConclusionsThe combination of cisplatin plus mitomycin C showed promising results in BRCA1-driven OC and therefore deserves further clinical evaluation.

scholarly journals Clinical significance of primary debulking surgery and neoadjuvant chemotherapy-interval debulking surgery in advanced ovarian cancer

2020 ◽  
Vol 50 (4) ◽  
pp. 379-386
Author(s):  
Shin Nishio ◽  
Kimio Ushijima
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Clinical Significance ◽  
Performance Status ◽  
Advanced Ovarian Cancer ◽  
Stage Iii ◽  
Current Evidence ◽  
Debulking Surgery ◽  
Primary Debulking Surgery ◽  
Interval Debulking Surgery

Abstract Primary debulking surgery followed by platinum-based chemotherapy remains the standard treatment of patients with stage III–IV epithelial ovarian cancer. Neoadjuvant chemotherapy is an alternative treatment regimen that can be considered in selected patients. Complete cytoreduction, both through primary debulking surgery and interval debulking surgery, has a major positive effect on survival and should be the goal, even if this requires extensive surgery. When thorough assessment of tumor spread and performance status of the patient indicates that complete primary cytoreduction is not feasible without unacceptable morbidity, then alternative therapeutic strategies, such as neoadjuvant chemotherapy, must be considered. Such patients can be offered the option of interval debulking surgery after checking their response to neoadjuvant chemotherapy and resolution of the initial obstacles for primary debulking surgery (i.e. complete response of irresectable disease and improvement of the performance status). Current evidence suggests that a selected group of patients with International Federation of Gynecology and Obstetrics stage III–IV ovarian cancer will benefit from NAC-IDS. Research is ongoing to identify patients who might derive the greatest benefit from neoadjuvant chemotherapy followed by interval debulking surgery, instead of primary debulking surgery, on the basis of radiological, genetic, pathological, and immunological variables. In this review, we discuss current knowledge about the clinical significance of primary debulking surgery and neoadjuvant chemotherapy in advanced ovarian cancer and discuss unanswered questions in the field.

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