Multiple Cycles of Neoadjuvant Chemotherapy Associated With Poor Survival in Bulky Stage IIIC and IV Ovarian Cancer

Ren, Yu; Shi, Tingyan; Jiang, Rong; Yin, Sheng; Wang, Pan; Zang, Rongyu

doi:10.1097/igc.0000000000000517

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…These findings support that survival is maximized when residual disease is minimized after complete cytoreduction and chemotherapy [23]. Moreover, we found that neoadjuvant chemotherapy was independently associated with OS, which was consistent with our previous retrospective study [15]. Likewise, in 2017, Petrillo et al reported that in the subgroup of BRCA1/2 non-mutation carriers, patients with neoadjuvant chemotherapy had a worse PFS than those with primary debulking surgery, but no significant difference was found in BRCA1/2 mutation carriers, nor in the estimation of OS [24].…”

Section: Discussionsupporting

confidence: 82%

“…The detailed clinical and pathological information was extracted from the institutional patients' database, including age at diagnosis, tumor histopathology, grade, International Federation of Gynecology and Obstetrics (FIGO) stage, neoadjuvant chemotherapy, chemotherapeutic response, and residual disease (RD For those patients who were diagnosed with both ovarian carcinoma and breast cancer, survival estimations were confirmed by the reason of death or recurrence. As described previously, complete cytoreduction was defined as no grossly visible tumor in overall after surgical procedure [15].…”

Section: Study Subjectsmentioning

confidence: 99%

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Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Shi

Wang

Tang

et al. 2018

Cell Physiol Biochem

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Background/Aims: Prognostic value of germline BRCA1 or BRCA2 (gBRCA1/2) mutations in epithelial ovarian cancer (EOC) remains controversial, especially in the estimation of long-term survival. We previously reported the largest study of gBRCA1/2 mutation prevalence in Chinese EOC patients. The aim of this study is to further illustrate the correlation of residual disease and survival in BRCA-associated EOC in China. Methods: In the current cohort consisting of 615 cases from the Chinese EOC genome-wide association study, we evaluated the association between gBRCA1/2 mutation and clinical outcomes. Results: Overall, we did not find any significant difference between gBRCA1/2 mutation carriers and non-carriers in both progression-free survival (PFS) and overall survival (OS) (19.3 vs. 18.1 months and 77.2 vs. 73.2 months, P=0.528 and 0.147, HR 0.93 and 0.79, 95%CI 0.74-1.17 and 0.57-1.09, respectively). However, within three years after diagnosis, mutation carriers showed a longer OS than non-carriers (P=0.018, HR 0.53, 95%CI 0.31-0.90). Such a survival advantage decreased along with the extension of follow-up time. Quite interestingly, in the subgroup of patients with gross residual disease, mutation carriers had a longer survival than non-carriers (18.5 vs. 15.1 months and 68.5 vs. 54.3 months, P=0.046 and 0.038, HR 0.74 and 0.65, 95% CI 0.55-1.00 and 0.43-0.98, for PFS and OS respectively). Conclusions: Our findings provided the evidence that gBRCA1/2 mutation was not associated with survival in Chinese EOC patients, which possibly attributed to more than 37% of the patients without gross residual disease. Survival benefit of gBRCA1/2 mutation was prominent in ovarian cancer patients with gross residual disease.

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Section: Discussionsupporting

confidence: 82%

Section: Study Subjectsmentioning

confidence: 99%

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Shi

Wang

Tang

et al. 2018

Cell Physiol Biochem

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“…Therefore, the goal of debulking surgery has been changed from the presence of a residual tumor less than 1 cm in diameter to the presence of no visible tumor 21 ; however, advanced-stage disease is associated with a low rate of complete tumor resection 22 . A previous study demonstrated that patients who received IDS after NACT were likely to achieve optimal cytoreduction 20,23 but that they did not have superior survival 24 , and there was a decreasing trend in median survival with an increase in the number of NACT cycles 24,25 . These studies suggest that NACT impacts the evaluation of tumor spread and leads to incomplete tumor resection in potentially resectable areas.…”

Section: Discussionmentioning

confidence: 98%

Advanced stage ovarian cancer patients with neoadjuvant chemotherapy suffered worse recurrence free survival

Zhou

Feng

et al. 2020

Preprint

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Background Neoadjuvant chemotherapy (NACT) has been applied for the treatment of patients with advanced-stage epithelial ovarian cancer (EOC), fallopian tube cancer, and primary peritoneal cancer, as these patients have a low likelihood of achieving optimal debulking and are thus poor surgical candidates. Herein, we explore the effects of NACT and compare the surgical outcomes and recurrence data in patients who receive interval debulking surgery followed NACT(NACT-IDS) or primary debulking surgery(PDS). Methods A retrospective, single-center, observational study was conducted. Patients with advanced-stage EOC, fallopian tube cancer and primary peritoneal cancer who were treated with NACT or primary debulking surgery were enrolled. The effects of NACT as well as the surgical outcomes and recurrence data were compared between the NACT-IDS and PDS groups. Results The albumin level was elevated (42.61±3.46 g/L vs. 37.47±5.42 g/L, P=0.001) and the levels of CA12-5 and HE4 significantly decreased (P=0.002, 0.003) in patients after neoadjuvant courses. The operation time, amount of blood loss during surgery, rate of bowel resection, time to chemotherapy, and platinum-free interval were comparable between the two groups (P＞0.05). Recurrence-free survival was worse in the NACT-IDS group than in the PDS group (HR=2.406, 95% CI[1.024, 5.657]). Conclusion NACT improved the condition of advanced-stage patients, but a poor recurrence free survival rate was observed; thus, NACT should not be applied in non-selected patients.

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“…Ovarian cancer is one of the three most common types of malignant tumors of the female reproductive system (1). It accounts for ~25% of female genital system neoplasms (2), with the highest mortality rate.…”

Section: Introductionmentioning

confidence: 99%

“…It accounts for ~25% of female genital system neoplasms (2), with the highest mortality rate. In addition, according to official statistics, the incidence of ovarian cancer is increased in 2012 in China (1). The majority of patients with ovarian cancer are diagnosed with the disease at an advanced stage (3) and therefore, are not suitable for treatment by surgical resection due to pelvic cavity, intraperitoneal and lymphatic metastasis, and adjacent organ infiltration (4).…”

Section: Introductionmentioning

confidence: 99%

Dioscin suppresses the viability of ovarian cancer cells by regulating the VEGFR2 and PI3K/AKT/MAPK signaling pathways

Guo

Ding

2018

Oncol Lett

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Diosgenin is a natural steroidal saponin that is extracted from a range of sources, including from fenugreek. It is a critical raw material in the synthesis of steroid hormone drugs, exhibiting antitumor, anti-inflammatory, antioxidation and a number of other significant pharmacological actions, possessing high pharmaceutical value. The aim of the present study was to investigate the effects of dioscin suppression on ovarian cancer cell growth and the mechanism of apoptosis induction by dioscin in ovarian cancer cells. The results of the present study demonstrated that dioscin decreased viability and induced apoptosis in SKOV3 human ovarian cancer cells in a dose-dependent manner. Dioscin significantly increased caspase-3 and caspase-9 activity, and increased the protein expression of Bax and cleaved poly(ADP-ribose) polymerase in SKOV3 cells. In addition, dioscin significantly suppressed vascular endothelial growth factor receptor (VEGFR)2, phosphoinositide 3-kinase (PI3K), phosphorylated AKT and phosphorylated p38 mitogen-activated protein kinase (MAPK) protein expression in SKOV3 cells. Taken together, to the best of our knowledge, the present study demonstrated for the first time that dioscin suppresses cell viability in ovarian cancer cells by regulating the VEGFR2 and PI3K/AKT/MAPK signaling pathways.

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Multiple Cycles of Neoadjuvant Chemotherapy Associated With Poor Survival in Bulky Stage IIIC and IV Ovarian Cancer

Abstract: Neoadjuvant chemotherapy was associated with poor survival of patients with bulky stage IIIC and IV ovarian cancer. A well-designed randomized trial with a better quality control of surgical procedures is needed to confirm the results.

Cited by 13 publications

References 26 publications

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Survival Benefit of Germline BRCA Mutation is Associated with Residual Disease in Ovarian Cancer

Advanced stage ovarian cancer patients with neoadjuvant chemotherapy suffered worse recurrence free survival

Dioscin suppresses the viability of ovarian cancer cells by regulating the VEGFR2 and PI3K/AKT/MAPK signaling pathways

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