Current management of epithelial ovarian carcinoma: A review

Marsden, Donald E.; Friedlander, Michael; Hacker, Neville F.

doi:10.1002/1098-2388(200007/08)19:1<11::aid-ssu3>3.0.co;2-3

Cited by 72 publications

(42 citation statements)

References 108 publications

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“…15 All patients diagnosed with what appears to be resectable disease undergo surgery with the intent of performing optimal abdominopelvic cytoreductive surgery. We believe that a maximal surgical effort should be employed, and we recently reported a statistically significant increase in optimal debulking rates at our institution by incorporating extensive upper abdominal procedures into our surgical approach.…”

Section: Discussionmentioning

confidence: 99%

The clinical significance of malignant pleural effusions in patients with optimally debulked ovarian carcinoma

Eitan

Levine

Abu‐Rustum

et al. 2005

Cancer

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BACKGROUNDThe objective of this study was to determine the impact of malignant pleural effusions on survival in patients with optimally debulked, advanced epithelial ovarian carcinoma.METHODSThe authors conducted a retrospective review of all patients with advanced epithelial ovarian carcinoma who underwent optimal primary cytoreduction at their institution between January 1987 and August 2000. Survival rates were compared between patients with optimally debulked Stage IIIC epithelial ovarian carcinoma and patients with optimally debulked Stage IV epithelial ovarian carcinoma (according to the International Federation of Gynecology and Obstetrics [FIGO] staging system) based on cytology‐proven malignant pleural effusions.RESULTSNinety‐nine patients were identified, and 97 of those patients were evaluable. The group with Stage IIIC disease included 76 patients, and the group with Stage IV disease included 21 patients. The median age at diagnosis was 55 years (range, 26–88 years). The majority of patients received platinum‐based chemotherapy after undergoing optimal primary cytoreduction. Age, tumor grade and histology, and the percentage of patients with ascites were similar in the two groups. The median survival rate was 58 months for patients who had Stage IIIC disease and 30 months for patients who had Stage IV disease (P = 0.016).CONCLUSIONSAlthough both groups underwent optimal cytoreduction in the abdomen/pelvis and were treated in a similar fashion, the median survival rate of patients with malignant pleural effusions was significantly shorter than the survival of patients without effusions. Many factors that led to or were manifested by pleural effusions, such as undetected bulky residual intrathoracic disease, may have been the cause for this survival difference. In the patients with effusions, one or more of these contributing factors may have led to the observed decreased survival rate, warranting further investigation. Cancer 2005. © 2005 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

The clinical significance of malignant pleural effusions in patients with optimally debulked ovarian carcinoma

Eitan

Levine

Abu‐Rustum

et al. 2005

Cancer

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“…In 2006, it was estimated that 20 180 women will be diagnosed with ovarian cancer, and 15 310 will die of the disease (Jemal et al, 2006). The standard of care in the treatment of patients with advanced-stage epithelial ovarian cancer includes primary cytoreduction surgery, followed by a platinum-based chemotherapy regimen (Marsden et al, 2000;Bristow et al, 2002).…”

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confidence: 99%

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

et al. 2007

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The aim of the study is to determine the role of lymphadenectomy in advanced epithelial ovarian cancer. The data were obtained from the Surveillance, Epidemiology and End Results (SEER) program reported between 1988 and 2001. Kaplan -Meier estimates and Cox proportional hazards regression models were used for analysis. Of 13 918 women with stage III -IV epithelial ovarian cancer (median age: 64 years), 87.9% were Caucasian, 5.6% African Americans, and 4.4% Asians. A total of 4260 (30.6%) underwent lymph node dissections with a median number of six nodes reported. For all patients, a more extensive lymph node dissection (0, 1, 2 -5, 6 -10, 11 -20, and 420 nodes) was associated with an improved 5-year disease-specific survival of 26.1, 35.2, 42.6, 48.4, 47.5, and 47.8%, respectively (Po0.001). Of the stage IIIC patients with nodal metastases, the extent of nodal resection (1, 2 -5, 6 -10, 11 -20, and 420 nodes) was associated with improved survivals of 36.9, 45.0, 47.8, 48.7, and 51.1%, respectively (P ¼ 0.023). On multivariate analysis, the extent of lymph node dissection and number of positive nodes were significant independent prognosticators after adjusting for age, year at diagnosis, stage, and grade of disease. The extent of lymphadenectomy is associated with an improved disease-specific survival of women with advanced epithelial ovarian cancer.

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“…[1][2][3][4] In most autopsy reports from the last 3 decades that deal with the metastatic pattern of EOC the uterus is not listed as a metastatic site [6][7][8][9][10] probably because the patients underwent a hysterectomy before they died of the disease. In only one study of 100 autopsies of ovarian cancer 11 it is reported that the uterine serosa, the myometrium and the cervix were involved in 27%, 10%, and 3% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] However, to the best of our knowledge, the rationale for hysterectomy at the initial operation is not clear. Possible reasons might be a high frequency of uterine involvement by the tumor and its potential impact on survival.…”

Section: Introductionmentioning

confidence: 99%

Uterine metastases in ovarian carcinoma: frequency and survival in women who underwent hysterectomy

2010

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Objective: Possible reasons for hysterectomy in the initial surgical management of advanced invasive epithelial ovarian carcinoma (EOC) might be a high frequency of uterine involvement and its impact on survival. The aim of the present study was to describe the frequency of uterine involvement and its association with survival in an unselected population of EOC patients who underwent hysterectomy. Methods: All incident cases of EOC diagnosed in Israeli Jewish women between March 1994 to June 1999, were identified within the framework of a nationwide case-control epidemiological study. The target population of the present report includes all stage II-IV EOC patients who had a uterus at the time of diagnosis. Of the 822 such patients, 695 fulfilled the inclusion criterion. Excluded were 141 patients for various reasons. The present analysis is based on the remaining 554 patients. Results: Uterine involvement was present in 291 (52.5%) of the patients and it was macroscopic in only 78 (14.1%). The serosa was the most common site of isolated metastases. Multivariate analysis showed that advanced stage significantly increased the risk for uterine involvement. The overall median survival with any uterine involvement was significantly lower compared to those with no involvement (38.9 months vs. 58.0 months; p＜0.001). Conclusion:There is an association between uterine involvement, whether macro-or microscopic, and lower survival even after hysterectomy although residual tumor could not be included in the analysis. Further studies are required to establish whether uterine involvement itself is an unfavorable risk factor or merely a marker of other unfavorable prognostic factors.

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Current management of epithelial ovarian carcinoma: A review

Cited by 72 publications

References 108 publications

The clinical significance of malignant pleural effusions in patients with optimally debulked ovarian carcinoma

The clinical significance of malignant pleural effusions in patients with optimally debulked ovarian carcinoma

The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13 918 patients

Uterine metastases in ovarian carcinoma: frequency and survival in women who underwent hysterectomy

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