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).

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.

scholarly journals The Results of Cytoreductive Operations in Patients with Colorectal Cancer with Simultaneous Liver Polymetastases

2018 ◽  
Vol 3 (2) ◽  
pp. 54-59
Author(s):  
SV V Kozlov ◽  
OI I Kaganov ◽  
AE E Orlov ◽  
AM M Kozlov
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastases ◽  
Cytoreductive Surgery ◽  
Stage Iv ◽  
Long Term Results ◽  
Control Group ◽  
Results Of Treatment ◽  
Cytoreductive Treatment

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.

scholarly journals Recurrent Ovarian Cancer with the Involvement of Urinary Organs: is There Place for Secondary Cytoreductive Surgery?

2017 ◽  
Vol 24 (3) ◽  
Author(s):  
Kateryna Kharchenko
Keyword(s):  
Ovarian Cancer ◽  
Median Survival ◽  
Cytoreductive Surgery ◽  
Postoperative Mortality ◽  
Recurrent Ovarian Cancer ◽  
Long Term Results ◽  
Secondary Cytoreductive Surgery ◽  
Urological Surgery ◽  
Urological Complications

The objective of the research was to estimate early and long-term results of secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs. Materials and methods. The study included 62 patients with recurrent ovarian cancer treated in the Institute of General and Emergency Surgery named after V.T. Zaitsev of the Academy of Medical Sciences of Ukraine during January 2009 – September 2015. Selection criteria for secondary cytoreductive surgery were the following: recurrent ovarian cancer with involvement of the bladder and/or the ureter, no urologic surgery during primary cytoreductive surgery, the ECOG performance status of 0-2. Urological surgery that had been a subject to the analysis was the following: cystoscopy with or without intraoperative urethral stenting, bladder resection, ureterectomy, ureteral reimplantation, cystectomy with further reconstruction. Evaluation criteria included the presence and the level of surgical and postoperative urological complications within 30 days after surgery, relaparatomy rates, postoperative mortality, type of cytoreduction. Long-term results were evaluated through recurrence rates after secondary cytoreductive surgery, median survival, disease-free survival and overall survival.Results. Volumes of performed surgery (excluding urological one) were the following: lymphadenectomy (n=29; 46.7%), bowel resection (n=17; 27.4%), vascular resection (n=4; 6.5%) and others. Minimally invasive urological surgery included urethral stenting (n=6; 9.7%) and cystoscopy (n=13; 20.9%). Bladder resection was performed in 26 (41.9%) cases, cystectomy – in 17 (27.4%) cases. R0 resections were performed in all the cases. Postoperative non-urological complications were observed in 7 (11.2%) patients. Urological complications were found in 9 (14.5%) patients. Postoperative mortality was 3.2%. Recurrence was documented in 7 (11.3%) cases. Median survival was 24 months. Follow-up mortality was 30% (n=18).Conclusions. The results of combined secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs indicate the possibility of en bloc resection of tumor and surrounding organs at acceptable rates of postoperative complications and mortality. Extended combined surgery and even pelvic exenteration are effective in treatment of patients with recurrent ovarian cancer.

Inflammatory disease of the womans reproductive system: modern trends in diagnosis and therapy (literature review)

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 35-41
Author(s):  
T Yu Pestrikova ◽  
I V Yurasov ◽  
E A Yurasova
Keyword(s):  
Genital Tract ◽  
Inflammatory Diseases ◽  
Diagnosis And Treatment ◽  
Long Term Results ◽  
Modern Approach ◽  
Pelvic Organs ◽  
Results Of Treatment ◽  
Number Of Patients ◽  
Diagnostic Approaches

Medical, social and economic relevance of inflammatory diseases of the woman's reproductive organs requires a very careful attitude to the diagnosis and treatment of this pathology. The number of patients with genital infections and inflammatory diseases of the pelvic organs can takes the first place in structure of gynecological morbidity, and is 60.4-65.0%, and this fact is not unique to Russia, but all over the world. Incidence rate of inflammatory diseases of the pelvic organs in the first decade of the twenty-first century is increased at 1.4 times in patients who are from 18 to 24 years old and at 1.8 times in patients aged 25-29 years. At the same time, the cost of diagnosis and treatment has increased, reaching 50-60% of the total cost of providing gynecological care for population. The inflammatory diseases of pelvic organs are a collective concept. It includes of various nosological forms. There are numerous contradictions in the views on diagnostic approaches and treatment tactics, the nature of screening and control over the long-term results of treatment, the etiological and pathogenetic significance of various microorganisms found in the genital tract in patients with inflammatory diseases of the pelvic organs. Currently, there are many opinions among specialists about diagnostic approaches and treatment tactics, the type of screening and monitoring the long-term results of treatment, the etiological and pathogenetic role of various microorganisms which can be found in the genital tract in patients with inflammatory diseases. This review presents the results of a modern approach to the diagnosis, management and rehabilitation of patients with inflammatory diseases of the pelvic organs.

Lumbar periarticular cysts of arcorray joint

2020 ◽  
pp. 47-57
Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter
Keyword(s):  
Minimally Invasive ◽  
Severe Pain ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Lumbar Region ◽  
Results Of Treatment ◽  
Invasive Method ◽  
Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

Tensa retraction cholesteatoma: treatment and long-term results

1989 ◽  
Vol 103 (2) ◽  
pp. 149-157 ◽  
Author(s):  
T. Lau ◽  
M. Tos
Keyword(s):  
Ossicular Chain ◽  
Observation Time ◽  
Long Term Results ◽  
Mastoid Process ◽  
Canal Wall ◽  
Pars Tensa ◽  
Results Of Treatment ◽  
Acquired Cholesteatoma ◽  
Canal Wall Down

AbstractTo obtain the best possible results of treatment of acquired cholesteatoma, we made a subdivision of cholesteatoma types into attic and pars tensa cholesteatomas, and subdivided the latter further into tensa retraction cholesteatoma and sinus cholesteatomas. Tensa retraction cholesteatoma is defined as arising from a retraction or perforation of the whole pars tensa, whereas sinus cholesteatoma is defined as arising from a retraction or perforation of the postero-superior part of the tensa. We present the long-term results obtained in tensa retraction cholesteatomas treated with one stage surgery from 1964 to 1980. Median observation time was 9 years, range 2 to 19 years. Sixty-one ears were treated without mastoidectomy, whereas 71 ears had canal wall-up mastoidectomy and 64 ears had canal wall-down mastoidectomy. The total recurrence rate was 13.3 per cent; 17 ears had residual cholesteatoma, and nine ears had recurrent cholesteatoma. The best results were obtained in ears with an intact ossicular chain where mastoidectomy was not performed. In 49 per cent of the cases, the cholesteatoma was confined to the tympanic cavity without reaching the aditus, antrum or mastoid process. About one-third to one-quarter of the ears had tympanoplasty only, with removal of the cholesteatoma through the ear canal.

Long-term results of treatment of patients with limb arterial embolism

1986 ◽  
Vol 67 (4) ◽  
pp. 300-300
Author(s):  
I. I. Strelnikov
Keyword(s):  
Myocardial Infarction ◽  
Causes Of Death ◽  
Long Term Results ◽  
Peripheral Artery ◽  
Arterial Embolism ◽  
Cardiac Defects ◽  
Results Of Treatment ◽  
Artery Embolism ◽  
Conservative And Surgical Treatment

We followed the fate of 166 patients with limb arterial embolism in the late stage of the disease after conservative and surgical treatment from 6 months to 10 years. Of 166 patients, 44 (26.5%) died after hospital discharge. Thirty of them were older than 61 years. The most frequent causes of death in the long-term period were acute cerebrovascular disease (11), myocardial infarction (7), progressive cardiovascular insufficiency due to cardiac defects (6), repeated peripheral artery embolism causing limb gangrene (7). In 7 patients the cause of death was not determined.

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