Factors influencing survival in Stage I ovarian cancer

Webb, Maurice J.; Decker, David G.; Mussey, Elizabeth; Williams, Tiffany J.

doi:10.1016/0002-9378(73)91054-5

Cited by 153 publications

(44 citation statements)

References 8 publications

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“…The analysis of various prognostic factors indicates as main factor the grade differentiation of the tumour. This finding is consistent with the results of previous studies (Webb et al, 1973;Sevelda et al, 1989;Ahmed et al, 1996). Thus, tumour grading is the main factor in the identification of patients with early ovarian cancer who could benefit from adjuvant chemotherapy.…”

Section: Discussionsupporting

confidence: 93%

“…This finding is consistent with previous published studies that showed 5-year survival rates raging from 75% to 90% (Webb et al, 1973;Einhorn et al, 1985;Sevelda et al, 1989;Dembo et al, 1990;Lund & Williamson, 1991;Shueler et al, 1993;Ahmed et al, 1996). The analysis of various prognostic factors indicates as main factor the grade differentiation of the tumour.…”

Section: Discussionsupporting

confidence: 92%

“…Some authors have suggested that age, tumour grade, stage and rupture of the tumour capsule have a relevant impact on the survival of early ovarian cancer patients (Webb et al, 1973;Einhom et al, 1985). A recent study including 194 patients with stage I ovarian cancer identified grade, presence of ascites and surface tumour as independent prognostic factors (Ahmed et al, 1996).…”

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confidence: 99%

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Survival and prognostic factors of early ovarian cancer

Villa

Parazzini²,

Acerboni³

et al. 1998

Br J Cancer

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Summary Survival and prognostic factors were analysed in 150 patients with histologically confirmed epithelial ovarian cancer stage IA-IIA. The relapse-free and overall survival rates were, respectively, 81 % and 88% after 3 and 74% and 84% after 5 al, 1996). Other studies, however, did not confirm these indications (Dembo et al, 1986(Dembo et al, , 1990 Kaplan-Meier and compared using the log-rank test. The Cox model (Cox, 1972) was fitted to the data after graphical check of proportional hazards assumption to evaluate the prognostic value of considered factors, taking into account the potential reciprocal confounding effect.At the time of the study analysis, 39 women had relapsed and 29 had died (27 out of the 39 who relapsed and 2 out of Ill with no recurrence of disease for causes unrelated to ovarian cancer).The relapse-free and overall survival rates were, respectively, 81% and 88% after 3 years and 74% and 84% after 5 years.Patients 53 years old or less tended to have a better 5-year survival rate (88%) than the older ones (79%; log-rank test P = 0.04, multivariate analysis P = 0.07).

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

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Survival and prognostic factors of early ovarian cancer

Villa

Parazzini²,

Acerboni³

et al. 1998

Br J Cancer

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“…This can be accomplished by en bloc removal of the tumor, with or without controlled drainage of the tumor fluid. Removal of the tumor en bloc is thought by some to decrease the risk of spilling potentially malignant cells [8].…”

Section: Discussionmentioning

confidence: 99%

A Case of Giant Ovarian Cyst Managed Successfully Through Laparoscopic Surgery

Kim

Park

et al. 2012

Korean J Obstet Gynecol

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Mucinous ovarian tumors account for 15% all ovarian neoplasms, of which giant variants rarely occur. Recently huge ovarian cysts (more than 12 kg) are now rarely seen because of the development in health care systems and education. The patient is 26-yearold nulligravida female who presented with abdominal distension. A laparoscopic left salpingo-oophorectomy was performed. Laparoscopic approach to giant ovarian cyst may be difficult regarding the risk of cyst rupture and limited working space. To reduce the limitations of the laparoscopy, we performed laparoscopy after aspirating the cystic contents. During laparoscopy, abdominal cavity was explored by the scope. Cyst contained about 53 L of fluid. The histopathologic examination revealed a borderline mucinous tumor of the left ovary. Laparoscopic excision of giant ovarian cyst seems to be safe and applicable treatment modality. Copyright © 2012. Korean Society of Obstetrics and GynecologyLaparoscopic approach is more advantageous over laparotomy, considering better cosmetic results, lesser blood loss, lesser pain and analgesic requirement, faster recovery, and shorter hospitalization time [1]. Laparoscopic approach to giant ovarian cyst, in cases when the cysts' sizes exceed to the umbilicus, may be difficult regarding the risk of cyst rupture and limited working space [2]. However, if the laparotomy is chosen as the operative treatment, a larger incision is required to excise the cyst. We present a case of laparoscopic extirpation of a giant ovarian cyst. Case ReportA 26-year-old woman was referred to our department for a giant abdominal mass in July 2011. She was single and nulliparous female who presented with a gradually increasing abdominal swelling first noticed 4 years ago. Due to the huge mass she was unable to walk and had anorexia and weight gain. At admission, the emaciated patient weighted 120 kg, had a body height of 177 cm and abdominal girth at the level of the umbilicus was 190 cm (Fig. 1). There was no history of colicky pain fainting attacks, vomiting or other gastrointestinal attacks. She had no previous history of any illnesses, allergies or operations. On abdominal examination, abdomen was grossly distended engorged veins present, fluid thrill was present. There were no abnormalities in hematologic and biochemical data including cancer biomarkers CA-125, CA 19-9, and carcinoembryonic antigen. On ultrasonography, a huge, multilocular cystic tumor with low echogenic content was found (Fig. 2). There were no papillary or solid parts of associated with the wall or septa, and no ascites. She could not fit into the computed tomography machine due to the giant abdominal mass. After consultation with the anesthesiology and cardiology teams, the patient was placed in a semiFowler's position in the operating room due to dyspnea, general anesthesia and endotracheal tube intubation was performed. After CASE REPORT Korean J Obstet Gynecol 2012;55(7):534-537 http://dx

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“…23 They concluded that complete surgical removal, unilaterality and low-grade histology were good prognostic factors, whereas high-grade histology, rupture of the cyst, adherence to other structures and extracystic excrescences were poor prognostic factors. This study was performed, in part, before standardization by the FIGO classification came into place.…”

Section: The Significance Of Capsular Rupture and The Effect Of Adjuvmentioning

confidence: 99%

Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy

Rouzi

McComb

1997

Ann Saudi Med

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AA Rouzi, PF McComb, Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy. 1997; 17(3): 321-325 Operative laparoscopy is gaining popularity and widespread application in gynecology. In response to a survey on operative laparoscopy by the American Association of Gynecologic Laparoscopists, the laparoscopic management of ovarian cysts was the third most common procedure reported.1 Technological advances and appropriate training have allowed ovarian cystectomy to be performed laparoscopically. In this review, we assess the best available diagnostic means to select cases suitable for laparoscopic ovarian cystectomy to prevent inadvertent rupture of ovarian malignancy and to appraise the consequences of rupture of ovarian malignancy if it occurs. Diagnostic Tests and Selection of Patients History and Physical ExaminationHistorically, ovarian cancer has been described as occult disease with an insidious onset of nonspecific symptomatology. A disease of older age, the risk of ovarian malignancy is 12.1 times greater for the 60-69-year age range as compared with the 20-29-age range.2 And the overall risk of malignancy in an ovarian neoplasm increases from 13% in premenopausal women to 45% in postmenopausal women. The use of a physical examination to differentiate benign from malignant disease is based upon certain characteristics, including bilaterality, presence of cystic/solid components, mobility of the pelvic structures, irregularity of the cyst surface, ascites and cul-de-sac nodularity.3 However, these characteristics are nonspecific and some (cystic/solid components or irregularities of the cyst) are best addressed ultrasonographically. Tumor MarkersCirculating tumor markers are used increasingly in the diagnosis and management of gynecologic malignancy. A detailed discussion of tumor markers is beyond the focus of this review. The most commonly used marker for epithelial ovarian cancer is CA 125, a tumor-associated antigen that can be recognized by the specific monoclonal antibody and that is present in 80% of all patients with ovarian cancer. Forty percent of women with Stage I ovarian cancer will have elevated levels. 4 However, it can also be elevated in other physiological circumstances (menstruation and early pregnancy), in benign gynecologic conditions (endometriosis) and with other malignancies (pancreas, stomach, colon and rectum).To use CA 125 for identifying malignant pelvic masses, O'Connell et al. constructed a receiver operator characteristic (ROC) curve and determined that a cutoff of 35 U/mL achieves a sensitivity of 100%, a negative predictive value of 100%, a specificity of 43% and a positive predictive value of 60%. 5 The ROC curve describes the accuracy of a test over a range of cutoff points by depicting the tradeoff between sensitivity and specificity. It can also compare the validity of different diagnostic tests. In this series, however, it is necessary to consider the possibility of selection bias because of the high clinical suspici...

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Factors influencing survival in Stage I ovarian cancer

Cited by 153 publications

References 8 publications

Survival and prognostic factors of early ovarian cancer

Survival and prognostic factors of early ovarian cancer

A Case of Giant Ovarian Cyst Managed Successfully Through Laparoscopic Surgery

Laparoscopic Ovarian Cystectomy: Selection of Patients and Consequences of Rupture of Ovarian Malignancy

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