The role of Neoadjuvant Chemotherapy versus Primary Surgery in the Management of Stage III Ovarian Cancer

Gorp, Toon Van; Amant, Frédéric; Neven, Patrick; Berteloot, Patrick; Leunen, Karin; Vergote, Ignace

doi:10.1007/978-0-387-48993-3_25

Cited by 3 publications

(2 citation statements)

References 52 publications

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“…But recruitment of the European Organization for Research and Treatment of Cancer protocol 55971 comparing upfront debulking surgery versus neoadjuvant chemotherapy in patients with stage IIIc or IV epithelial ovarian cancer in a randomized phase III trial is almost completed. This trial will elucidate whether neoadjuvant chemotherapy is an alternative approach with the same outcome compared with the standard procedure, upfront surgery (36,37). Thus far, no reliable parameters exist to predict which patients are likely to benefit from preoperative chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Primary Tumor Levels of Human Tissue Kallikreins Affect Surgical Success and Survival in Ovarian Cancer Patients

Dorn

Kates

Schmalfeldt

et al. 2007

Clinical Cancer Research

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Purpose: Proteolytic factors of the human tissue kallikrein (hK) family and the plasminogen activation system play a key role in tumor progression in various malignancies. We determined antigen levels of urokinase-type plasminogen activator (uPA), its inhibitor PAI-1, and hK5-8, hK10, hK11, and hK13 by ELISA in primary tumor tissue extracts of 142 International Federation of Gynecology and Obstetrics (FIGO) I to IVovarian cancer patients (median follow-up 41months). Results: After radical surgery, absence of macroscopically visible residual tumor (RT) was achieved in 72 patients; all patients received postoperative platinum-containing chemotherapy. Significant univariate predictors of poor progression-free survival (PFS) were RT (>0), FIGO stages (III/IV versus I/II/III), ascites volume >500 mL, nodal status, and the difference between PAI-1 and uPA (fractionally ranked). In multivariate analysis, significant independent factors for poor PFS were RT [hazard ratio (HR), 4.53] and low hK11fractional rank (HR, 0.30). Univariate predictors of poor overall survival were RT, FIGO stages, nodal status, ascites volume, nuclear grade, and low hK10 and hK13. In multivariate analysis, significant independent factors for poor overall survival were RT (HR, 7.49), ascites (HR, 1.97), and low hK10 (HR, 0.196).We constructed a multivariate scoring model estimating RT probability, based on ascites [odds ratio (OR), 13.1], nuclear grade (OR, 2.92), hK6 (OR, 8.54), and hK13 (OR, 0.14), with good in-sample predictive performance (area under receiver operating characteristic, 0.833). Conclusions: In view of risks and benefits of radical surgery, such a score could support preoperative risk stratification and identify candidates for alternative therapeutic strategies. These results highlight the distinct roles of the hKs for different disease end points in ovarian cancer and their potential to support individualized therapy decisions.

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Section: Discussionmentioning

confidence: 99%

Primary Tumor Levels of Human Tissue Kallikreins Affect Surgical Success and Survival in Ovarian Cancer Patients

Dorn

Kates

Schmalfeldt

et al. 2007

Clinical Cancer Research

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“…El factor pronóstico más importante en COA es el tumor residual luego de una citorreducción máxima primaria. Hay discrepancias en la cantidad de tejido neoplásico residual considerado óptimo luego de la citorreducción, estimándose entre 0 y 3 cm (7,8). En nuestra unidad, consideramos como óptimo un residuo tumoral menor o igual a 1 cm.…”

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Laparoscopia en Cirugía Primaria Del Cáncer De Ovario Avanzado

et al. 2008

Rev. chil. obstet. ginecol.

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Describir los resultados de la laparoscopia abierta para certificar el diagnóstico y evaluar la resecabilidad tumoral de pacientes con cáncer de ovario avanzado (COA). Método: Se analizaron todas las fichas de pacientes con sospecha diagnóstica de COA entre octubre de 2005 y febrero de 2007 inicialmente manejadas con laparotomía abierta. Resultados: En 14 pacientes se certifico el diagnóstico de COA, de ellas se estimó posible la resecabilidad completa en 10 casos, lo cual se logró efectivamente en 9. En 4 casos la evaluación laparoscópica indicó irresecabilidad, derivándose las pacientes a quimioterapia neoadyuvante para una posterior cirugía de intervalo. Conclusión: Creemos que la laparoscopía en pacientes con sospecha de COA, podría cumplir un rol importante en la evaluación de la resecabilidad así como en la confirmación diagnóstica, evitando extensas laparotomías en pacientes inoperables en primera instancia y donde el inicio de una quimioterapia precoz podría mejorar significativamente su sobrevida.

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Management of Women With Newly Diagnosed Ovarian Cancer

Krasner

Duska

2009

Seminars in Oncology

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The role of Neoadjuvant Chemotherapy versus Primary Surgery in the Management of Stage III Ovarian Cancer

Cited by 3 publications

References 52 publications

Primary Tumor Levels of Human Tissue Kallikreins Affect Surgical Success and Survival in Ovarian Cancer Patients

Primary Tumor Levels of Human Tissue Kallikreins Affect Surgical Success and Survival in Ovarian Cancer Patients

Laparoscopia en Cirugía Primaria Del Cáncer De Ovario Avanzado

Management of Women With Newly Diagnosed Ovarian Cancer

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