The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma

Hoskins, William J.; McGuire, William P.; Brady, Mark F.; Homesley, Howard D.; Creasman, William T.; Berman, Michael L.; Ball, Harrison; Berek, Jonathan S.

doi:10.1016/s0002-9378(94)70090-7

Cited by 672 publications

(361 citation statements)

References 9 publications

Supporting

Mentioning

332

Contrasting

Unclassified

Order By: Relevance

“…The two treatment arms were well matched with respect to demographics and disease characteristics. Interestingly, like in other published series (Hoskins et al, 1994) less than 50% of included patients benefited of optimal debulking surgery.…”

Section: Resultssupporting

confidence: 67%

Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group

Paraïso

Leduc³

et al. 2007

Br J Cancer

View full text Add to dashboard Cite

ICON3 trial results have suggested that CAP and carboplatin -taxol regimens as first-line treatment of advanced ovarian cancer (AOC) yield similar survival. We explored the impact of increased dose of cyclophosphamide in a modified CAP regimen on the disease-free survival (DFS) and overall survival (OS) of AOC patients. From February 1994 to June 1997, 164 patients were randomised to receive six cycles every 3 weeks of either standard CEP (S) combining cyclophosphamide (C), 500 mg m À2 , epirubicin (E) 50 mg m À2 , and cisplatin (P) 75 mg m À2 or intensive CEP (I) with E and P at the same doses, but with (C) 1800 mg m À2 and filgrastim 5 mg kg À1 per day Â 10 days. Response was evaluated at second-look surgery. Patient characteristics were well balanced. Except for grade 3 -4 neutropaenia (S: 54%, I: 38% of cycles), Arm1 presented a significantly more important toxicity: infection requiring antibiotics, grade 3 -4 thrombocytopaenia, anaemia, nausea-vomiting, diarrhoea, mucositis. Median follow-up was 84 months. DFS (15.9 vs 14.8 months) and OS (33 vs 30 months) were not significantly different between S and I (P40.05). Increasing cyclophosphamide dose by more than 3 times with filgrastim support in the modified CAP regimen CEP induces more toxicity but not better efficacy in AOC. British Journal of Cancer (2007) Advanced ovarian cancer (AOC) is considered one of the most chemotherapy-sensitive epithelial malignant tumours (Ozols and Young, 1991;Trimble et al, 1994). First-line regimens with a platinum salt used alone or in combination (McGuire et al, 1996;Muggia et al, 2000) induce objective response in more than half of the patients. However, a majority ultimately relapse after a median interval which rarely exceeds 18 months (McGuire et al, 1996) suggesting the need of new therapeutic regimens.In the 1990s, the combination of cisplatin and paclitaxel was established as first-line therapy for AOC patients after two large phase III trials had demonstrated the superiority of this combination over the then standard regimen of cyclophosphamide and cisplatin (McGuire et al, 1996; Piccart et al, 2000). A number of studies have evaluated the combination of paclitaxel and carboplatin as an alternative to the paclitaxel -cisplatin regimen (Neijt et al, 2000;Bookman et al, 2003;Ozols et al, 2003). They have shown that the carboplatin combination is associated with a lower incidence of non-haematologic toxicities (particularly neurotoxicity) and better quality of life, whereas no significant difference in progression-free survival (PFS) and overall survival (OS) was detected. From these findings, the International Consensus Conference in Ovarian cancer, held in Baden-Baden in 2004, concluded that carboplatin -paclitaxel was the first-line standard for AOC treatment.This consensus however has been challenged by the results of two randomised trials comparing platinum -paclitaxel to alternative regimens. The GOG 132 study compared cisplatin alone (100 mg m À2 ), paclitaxel alone (200 mg m À2 over 24 h), and the combination ...

show abstract

Section: Resultssupporting

confidence: 67%

Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group

Paraïso

Leduc³

et al. 2007

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Among those with larger residual disease, size does not affect prognosis appreciably. [6] This study forms the basis of the GOG recommendation of optimal debulking which as residual implants <1 cm. The same authors retrospectively reviewed 394 patients from a GOG study all of whom had residual disease <1 cm and concluded that apart from the size of residual disease, the other factors influencing survival are extent of disease, age, tumor grade and the number of residual lesions.…”

Section: Rational For Complete Cytoreductive Surgery (Crs) For Stage mentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

View full text Add to dashboard Cite

Ovarian cancer is one of the leading causes of cancer related deaths in women worldwide. It is usually diagnosed in an advanced stage (Stages III and IV) when peritoneal cancer spread has already occurred. The standard treatment comprises of surgery to remove all macroscopic disease followed by systemic chemotherapy. Despite all efforts, it recurs in over 75 % of the cases, most of these recurrences being confined to the peritoneal cavity. Recurrent ovarian cancer has a poor long term outcome and is generally treated with multiple lines of systemic chemotherapy and targeted therapy. The propensity of ovarian cancer to remain confined to the peritoneal cavity warrants an aggressive locoregional approach. The combined treatment comprising of cytoreductive surgery (CRS) that removes all macroscopic disease and HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been effective in providing long term survival in selected patients with peritoneal metastases of gastrointestinal origin. Intraperitoneal chemotherapy used as adjuvant therapy has shown a survival benefit in ovarian cancer. This has prompted the use of CRS and HIPEC in the management of ovarian cancer as a part of first line therapy and second line therapy for recurrent disease. This article reviews the current literature and evidence for the use of HIPEC in ovarian cancer.

show abstract

“…The extent of cytoreduction was defined as optimal if the largest diameter of any residual lesion from surgery was smaller than 1 cm or suboptimal if residual disease was larger than 1 cm. 33,34 The use of tissue block and chart review was approved by the Institutional Review Board at M. D. Anderson Cancer Center.…”

Section: Patient Selectionmentioning

confidence: 99%

Low membranous expression of β-catenin and high mitotic count predict poor prognosis in endometrioid carcinoma of the ovary

et al. 2010

View full text Add to dashboard Cite

Mutations in the b-catenin gene are common in ovarian endometrioid carcinoma. Few studies have addressed the association of b-catenin expression with tumor characteristics and patient outcome, yielding controversial results. The purpose of this study was to retrospectively assess the expression of b-catenin in ovarian endometrioid carcinoma and correlate its expression with the Gynecologic Oncology Group's (GOG) grading system, clinicopathological characteristics, and patient survival. A total of 49 patients with primary ovarian endometrioid carcinoma were included in this study. A four-tier score grading system was used for the membranous staining (negative, weak, moderate, and strong) and the percentage of positive cells for the nuclear staining of b-catenin. The status of five morphometric parameters, nuclear morphology (uniform or pleomorphic), mitotic count, glandular pattern, degree of squamous differentiation, and status of papillary pattern, was assessed. We found that a low membranous expression of b-catenin and a high mitotic count (415 per 10 high-power fields) were significantly associated with poor prognosis and early recurrence of ovarian endometrioid carcinoma. In addition, cases with nuclear expression of b-catenin showed an intermediate overall survival risk and late disease recurrence. Young age at the time of diagnosis, advanced disease stage, and suboptimal debulking were among the clinical factors predicting poor survival and early disease recurrence. The presence of squamous differentiation, a papillary pattern or nuclear pleomorphism did not show any correlation with overall survival or disease-free survival. Low membranous expression of b-catenin and high mitotic count are poor prognostic indicators in patients with ovarian endometrioid carcinoma, whereas the GOG grading system showed no prognostic value. Our data suggest that there is a need to define a better grading system for ovarian endometrioid carcinoma. Molecular markers such as b-catenin and mitotic count could aid in defining this grading system.

show abstract

The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma

Cited by 672 publications

References 9 publications

Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group

Intensified dose of cyclophosphamide with G-CSF support versus standard dose combined with platinum in first-line treatment of advanced ovarian cancer a randomised study from the GINECO group

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Low membranous expression of β-catenin and high mitotic count predict poor prognosis in endometrioid carcinoma of the ovary

Contact Info

Product

Resources

About