Primary or Interval Debulking Surgery in Advanced Ovarian Cancer: a Personalized Decision—a Literature Review

Hudry, Delphine; Becourt, Stéphanie; Scambia, Giovanni; Fagotti, Anna

doi:10.1007/s11912-022-01318-9

Cited by 5 publications

(2 citation statements)

References 56 publications

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“…After binding to its receptors, PD-1 reduces the activity of T cells and mitigates damage to healthy cells. The mechanisms associated with PD-1 can affect its expression, and the functionality of toxic T cells will be limited with regards to the control of tumor immunity [12,13]. Karelizumab is a PD-1 inhibitor; after binding to PD-L1 on the surface of T lymphocytes and other cells, karelizumab will reduce mediated immunosuppression, activate more T cells, generate immune checkpoints, and kill tumor cells [14,15].…”

Section: Discussionmentioning

confidence: 99%

The efficacy of TP chemotherapy combined with karelizumab on the postoperative clinical status of patients with advanced ovarian cancer

2023

European Journal of Gynaecological Oncology

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To investigate the efficacy of TP (Toripalimab Plus) chemotherapy combined with karelizumab in the treatment of advanced ovarian cancer after surgery. We recruited 96 patients with advanced ovarian cancer who were admitted to our hospital between December 2019 and December 2022 with advanced ovarian cancer and treated by tumor cell reduction surgery. The patients were randomly divided into groups using a digital table, 48 each. The control group was treated with chemotherapy, while the observation group was treated with chemotherapy combined with karelizumab. We compared the two groups with regards to adverse reactions and the levels of VEGF (Vascular Endothelial Growth Factor), MMP-9 (matrixmetalloproteinase 9), CEA (A Carcinoma Embryonic Antigen), AFP (alpha-fetoprotein), CA125 (carbohydrate antigen 125), CA19-9 (carbohydrate antigen 19-9) and T lymphocytes. There was no significant difference between the two groups with regards to adverse reactions (p > 0.05); the levels of VEGF and MMP-9 in the observation group were lower. There was a significant difference between the data before and after treatment within the same group (all p < 0.05); the levels of CEA, AFP, CA125 and CA19-9 in the observation group were lower than those in the control group, with significant differences before and after treatment within the same group (p < 0.05); the levels of CD3+ (cluster of differentiation 3+) and CD4+ in the observation group were higher, while the levels of CD8+ were lower than those in the control group. There were significant differences before and after treatment in the same group (p < 0.05). The combination of karelizumab and TP chemotherapy had a significant and positive impact on postoperative patients with advanced ovarian cancer by effectively regulating immune function and the levels of tumor markers. This protocol is safe and can be selected by considering the specific situation of individual patients.

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Section: Discussionmentioning

confidence: 99%

The efficacy of TP chemotherapy combined with karelizumab on the postoperative clinical status of patients with advanced ovarian cancer

2023

European Journal of Gynaecological Oncology

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“…Previous studies have indicated that patients with advanced ovarian cancer who undergo debulking surgery have a more favorable prognosis compared to those who do not receive this treatment [ 6 , 7 ]. The amount of residual disease following debulking surgery is a significant prognostic indicator for patients [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of different treatment modalities on ovarian cancer patients with liver metastases: A retrospective cohort study based on SEER

Li,

Jin,

et al. 2024

PLoS ONE

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Background To examine the trends in morbidity and mortality among ovarian cancer patients with liver metastases, and investigate the impact of different treatments on both overall survival (OS) and cancer-specific survival (CSS). Methods 2,925 ovarian cancer patients with liver metastases from Surveillance, Epidemiology, and End Results 2010–2019 were included. The primary endpoint was considered as OS and CSS. We conducted trend analysis of the incidence, OS and CSS rates of liver metastases in ovarian cancer. Univariate and multivariate COX proportional risk models were used to investigate the association between different treatment methods and OS, and univariate and multivariate competing risk models were employed to evaluate the impact of treatment methods on CSS. Results At the end of follow-up, 689 patients remained alive. The OS and CSS rates were 76.44% and 72.99% for all patients, respectively. There was a significant decreasing trend in the incidence [average annual percent change (AAPC) = -2.3, 95% confidence interval (CI): -3.9, -0.7], all-cause mortality (AAPC = -12.8, 95% CI: -15.6, -9.9) and specific mortality (AAPC = -13.0, 95% CI: -16.1, -9.8) rate of liver metastases in ovarian cancer. After adjusting all confounding factor, only receiving surgery was associated with OS [hazard ratio (HR) = 0.39, 95%CI: 0.31–0.48]/CSS (HR = 0.37, 95%CI: 0.30–0.47). Chemotherapy was found to be protective factor for OS (HR = 0.33, 95%CI: 0.30–0.37)/CSS (HR = 0.44, 95%CI: 0.39–0.50) of ovarian cancer patients, while not receiving surgery remained a risk factor. Additionally, the result of subgroup analyses also showed that only receiving surgery and chemotherapy still were significant protective factor of OS and CSS for patients without other distant metastases, with distant metastases to the bone, lung, brain or other organs, with bone metastasis, and with lung metastasis. Conclusion Our research has elucidated a downward trend in morbidity and mortality rates among patients with liver metastases originating from ovarian cancer. Only receiving surgery and chemotherapy as therapies methods confer survival benefits to patients.

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Prognostic impact of microscopic residual disease after neoadjuvant chemotherapy in patients undergoing interval debulking surgery for advanced ovarian cancer

Di Donato,

Caruso,

Golia D’Augè

et al. 2024

Arch Gynecol Obstet

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Purpose To determine the prognostic impact of microscopic residual disease after neoadjuvant chemotherapy (NACT) in patients undergoing interval debulking surgery (IDS) for advanced epithelial ovarian cancer (AEOC). Methods Patients affected by FIGO stage IIIC–IV ovarian cancer undergoing IDS between October 2010 and April 2016 were selected. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier analysis. Results In total, 98 patients were identified. Four patients (4.1%) were considered inoperable. Overall, 67 patients (out of 94; 71.3%) had macroscopic disease, equating Chemotherapy Response Score (CRS) 1 and 2, 7 (7.4%) had microscopic residuals, equating CRS3, rare CRS2, while 20 (21.3%) had both microscopic and macroscopic disease. Median OS and PFS were, respectively, 44 and 14 months in patients with no macroscopic residual disease (RD = 0) compared to 25 and 6 months, in patients with RD > 0 (OS: p = 0.001; PFS: p = 0.002). The median PFS was 9 months compared to 14 months for patients with more or less than 3 areas of microscopic disease at final pathologic evaluation (p = 0.04). The serum Ca125 dosage after NACT was higher in patients with RD > 0 compared to those without residue (986.31 ± 2240.7 µg/mL vs 215.72 ± 349.5 µg/mL; p = 0.01). Conclusion Even in the absence of macroscopic disease after NACT, the persistence of microscopic residuals predicts a poorer prognosis among AEOC patients undergoing IDS, with a trend towards worse PFS for patients with more than three affected areas. Removing all fibrotic residuals eventually hiding microscopic disease during IDS represents the key to improving the prognosis of these patients.

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Primary or Interval Debulking Surgery in Advanced Ovarian Cancer: a Personalized Decision—a Literature Review

Cited by 5 publications

References 56 publications

The efficacy of TP chemotherapy combined with karelizumab on the postoperative clinical status of patients with advanced ovarian cancer

The efficacy of TP chemotherapy combined with karelizumab on the postoperative clinical status of patients with advanced ovarian cancer

Effect of different treatment modalities on ovarian cancer patients with liver metastases: A retrospective cohort study based on SEER

Prognostic impact of microscopic residual disease after neoadjuvant chemotherapy in patients undergoing interval debulking surgery for advanced ovarian cancer

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