We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Outcome in Advanced Ovarian Cancer following an Appropriate and Comprehensive Effort at Upfront Cytoreduction: A Twenty-Year Experience in a Single Cancer Institute.
- Authors
Marszalek, Anne; Alran, Séverine; Scholl, Suzy; Fourchotte, Virginie; Plancher, Corinne; Rosty, Christophe; Meyniel, Jean Philippe; De Margerie, Vincent; Dorval, Thierry; De La Rochefordière, Anne; Cottu, Paul; Petrow, Peter; Sastre-Garrau, Xavier; Salmon, Rémy Jacques
- Abstract
Objectives. The purpose of this retrospective evaluation of advanced-stage ovarian cancer patients was to compare outcome with published findings from other centers and to discuss future options for the management of advanced ovarian carcinoma patients. Methods. A retrospective series of 340 patients with amean age of 58 years (range: 17-88) treated for FIGO stage III and IV ovarian cancer between January 1985 and January 2005 was reviewed. All patients had primary cytoreductive surgery, without extensive bowel, peritoneal, or systematic lymph node resection, thereby allowing initiation of chemotherapy without delay. Chemotherapy consisted of cisplatin-based chemotherapy in combination with alkylating agents before 2000, whereas carboplatin and paclitaxel regimes were generally used after 1999-2000. Overall survival and disease-free survival were analyzed by the Kaplan-Meier method and the log-rank test. Results. With a mean followup of 101 months (range: 5 to 203), 280 events (recurrence or death) were observed and 245 patients (72%) had died. The mortality and morbidity related to surgery were low. The main prognostic factor for overall survival was postoperative residual disease (P < .0002), while the main prognostic factor for disease-free survival was histological tumor type (P < .0007). Multivariate analysis identified three significant risk factors: optimal surgery (RR = 2.2 for suboptimal surgery), menopausal status (RR = 1.47 for postmenopausal women), and presence of a taxane in the chemotherapy combination (RR = 0.72). Conclusion. These results confirm that optimal surgery defined by an appropriate and comprehensive effort at upfront cytoreduction limits morbidity related to the surgical procedure and allows initiation of chemotherapy without any negative impact on survival. The impact of neoadjuvant chemotherapy to improve resectability while lowering the morbidity of the surgical procedure is discussed.
- Subjects
OVARIAN cancer; RETROSPECTIVE studies; DISEASE management; HEALTH outcome assessment; DRUG therapy; ALKYLATING agents
- Publication
International Journal of Surgical Oncology, 2010, p1
- ISSN
2090-1402
- Publication type
Article
- DOI
10.1155/2010/214919