scholarly journals Clinical Practice of Adjuvant Chemotherapy in Patients with Early-Stage Epithelial Ovarian Cancer

Chemotherapy ◽  
2016 ◽  
Vol 61 (6) ◽  
pp. 287-294
Author(s):  
Lindy M.J. Frielink ◽  
Brenda M. Pijlman ◽  
Nicole P.M. Ezendam ◽  
Johanna M.A. Pijnenborg
Keyword(s):  
Ovarian Cancer ◽  
Clinical Practice ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Figo Stage ◽  
Selective Treatment ◽  
Platinum Based Chemotherapy ◽  
Grade 3 ◽  
Practice Methods

Background: Adjuvant platinum-based chemotherapy improves survival in women with early-stage epithelial ovarian cancer (EOC). Yet, there is a wide variety in clinical practice. Methods: All patients diagnosed with FIGO I and IIa EOC (2006-2010) in the south of the Netherlands were analyzed. The percentage of patients that received adjuvant chemotherapy was determined as well as the comprehensiveness of staging and outcome. Results: Forty percent (54/135) of the patients with early-stage EOC received adjuvant chemotherapy. Treatment with adjuvant chemotherapy was associated with FIGO stage, clear-cell histology and nonoptimal staging. Optimal staging was achieved in 50%, and nonoptimal staging was associated with advanced age, comorbidity and treatment in a non-referral hospital. Overall, there was no difference in outcome between patients with and without adjuvant chemotherapy. Yet, in grade 3 tumors, adjuvant chemotherapy seems beneficial. Conclusions: Selective treatment of patients with early-stage EOC might reduce adjuvant chemotherapy without compromising outcome.

Can Patients With Relapsed, Previously Untreated, Stage I Epithelial Ovarian Cancer Be Successfully Treated With Salvage Therapy?

2003 ◽  
Vol 21 (16) ◽  
pp. 3113-3118 ◽  
Author(s):  
Desiree F. Kolomainen ◽  
Roger A’Hern ◽  
Fareeda Y. Coxon ◽  
Cyril Fisher ◽  
D. Michael King ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Early Stage ◽  
Salvage Chemotherapy ◽  
Ovarian Neoplasm ◽  
Stage I ◽  
European Organization ◽  
Platinum Based Chemotherapy ◽  
Salvage Rate

Purpose: The role of adjuvant chemotherapy in early-stage epithelial ovarian cancer (EOC) has been controversial. We have previously reported the cases of patients managed with a policy of observation only. We now present the salvage rate for the patients in that study who experienced relapse. Patients and Methods: One hundred ninety-four patients with stage I EOC presenting between 1980 and 1994 received no adjuvant chemotherapy, but were treated with platinum-based chemotherapy at relapse. We calculated the progression-free survival (PFS) and overall survival (OS) for the whole cohort and the salvage rate for those who experienced relapse. We defined salvage as freedom from relapse for 5 years after platinum treatment. Results: Sixty-one (31%) of 194 patients experienced relapse, and 55 received platinum-based chemotherapy. Twenty-four percent were progression-free at 5 years after this treatment. Clear-cell histology and cyst rupture before the patients’ original surgery were independent prognostic factors for PFS after salvage chemotherapy. The OS for all 194 patients is 72% at 10 years (median follow-up, 8.7 years), with an 80% disease-specific survival (DSS). Conclusion: We have shown that some patients with stage I EOC can be successfully treated with a salvage chemotherapy regimen after a policy of observation only. Interestingly, approximately 30% of stage I patients who die within 10 years do so from causes other than EOC (OS, 72%; DSS, 80%). Our findings need to be taken into consideration when the results from recent randomized trials of adjuvant chemotherapy in this patient population (International Collaborative Ovarian Neoplasm Trial 1/European Organization for Research and Treatment of Cancer Adjuvant Chemotherapy in Ovarian Neoplasm Trial) are being discussed with patients.

scholarly journals Serous Epithelial Ovarian Cancer: Retrospective Analysis of 260 Cases

2021 ◽  
Vol 3 (1) ◽  
pp. 19-21
Author(s):  
Sedat Akgöl ◽  
Erhan Aktürk ◽  
İpek Yıldız Özaydın ◽  
Fatma Ölmez ◽  
Sema Karakaş ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Ca 125 ◽  
Recurrence Rates ◽  
Epithelial Ovarian Tumor ◽  
Platinum Based Chemotherapy ◽  
Training And Research ◽  
Serous Epithelial Ovarian Cancer ◽  
Grade 3

Objective: To evaluate the outcomes of patients who were followed up and treated for serous epithelial ovarian tumor. Materials and Methods: This retrospective study included 260 patients who were diagnosed with serous epithelial ovarian cancer, treated and followed up at Kanuni Sultan Suleyman Training and Research Hospital between January 2002 and December 2019. Results: The mean age of the patients participated in the study was 53.4±11.6 years. Of the patients, 79.7% had advance stage and 82.4% had grade 3 tumors. The rate of complete or optimal surgery was 88.2%, while the rate of suboptimal surgery was 11.2%. While 82% of the patients received adjuvant chemotherapy, 15.7% received neoadjuvant chemotherapy. Of the patients, 80.2% had a Ca 125 value higher than 35. Despite primary cytoreductive surgery and platinum-based adjuvant chemotherapy, the recurrence rate was 66.2%, and the PFS and OS rates were 34.7±41.0 and 50.5±40.0 months, respectively. Conclusion: The majority of serous epithelial ovarian cancers are diagnosed at an advanced stage. Despite primary situ reductive surgery and subsequent platinum-based chemotherapy, the recurrence rates are quite high.

scholarly journals Role of Reactive Thrombocytosis After Primary Cytoreductive Surgery in Advanced Ovarian Cancer

2021 ◽  
Author(s):  
Myeong-Seon Kim ◽  
Seung Hun Baek ◽  
Joseph J. Noh ◽  
Jung In Shim ◽  
Jun Hyeok Kang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adjuvant Chemotherapy ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Reactive Thrombocytosis ◽  
Entire Cohort ◽  
Platelet Counts ◽  
Advanced Epithelial Ovarian Cancer

Abstract We investigated the incidence of reactive thrombocytosis after maximal cytoreductive surgery in advanced epithelial ovarian cancer and its role on survival. We retrospectively reviewed electronic medical records of patients who underwent primary cytoreductive surgery for advanced epithelial ovarian cancer from January 1, 2012, and December 31, 2017. We analyzed the correlation serum platelet counts and prognosis at various time points including before surgery, during peri-operative period, and on each cycle of adjuvant chemotherapy.474 patients were eligible for the analysis. 401 patients (84.6%) were FIGO stage III and 405 patients (85.4%) were serous adenocarcinoma. 79 patients (22.6%) had splenectomy and optimal cytoreduction was achieved at 326 patients (68.8%). A week after surgery, thrombocytosis was observed in 229 patients (48.3%) patients in the entire cohort. Especially, higher platelet counts were observed in patients with splenectomy compared with patients without splenectomy. In particular, thrombocytosis on 5th cycle of adjuvant chemotherapy showed most significant impact on overall survival in multivariate analysis. In a logistic regression model, splenectomy significantly attributed to thrombocytosis on 5th cycle.Reactive thrombocytosis after primary cytoreductive surgery is associated with poor survival in advanced epithelial ovarian cancer, particularly when thrombocytosis was observed during adjuvant chemotherapy.

scholarly journals Chemotherapy is not necessary for early-stage serous and endometrioid ovarian cancer after undergoing comprehensive staging surgery

2020 ◽  
Author(s):  
Shuqing Li ◽  
Zhiling Zhu
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Stage ◽  
Platinum Based Chemotherapy ◽  
Number Of Patients ◽  
Staging Surgery ◽  
Endometrioid Ovarian Cancer

Abstract In order to investigate whether adjuvant chemotherapy is essential for patients with early-stage serous and endometrioid epithelial ovarian cancer, the present study collected data from the US Surveillance, Epidemiology and End Results database between 2004 and 2015. All subjects underwent comprehensive staging surgery and were diagnosed as stages IA-IIA, grade 1-2. A total of 2,644 patients were enrolled in the present study, among which 1,589 patients received platinum-based chemotherapy. Comparisons of categorical data were performed via χ2 tests. Variables with P<0.05 in univariate analyses were further analyzed using multiple logistic regression. Selection bias from the heterogeneity of demographic and clinical characteristics was avoided using propensity score matching. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), investigating the association between variables and 5-year overall survival. After the propensity score matching, there was an equal number of patients with or without chemotherapy (n=925). The results of the present study indicated that those aged ≥65 years were at an increased risk of ovarian cancer, and the age was associated with poor prognosis (HR, 1.486; CI, 1.208-1.827; P<0.001). Endometrioid carcinoma was associated with improved 5-year overall survival compared with serous cystadenocarcinoma (HR, 0.697; CI, 0.584-0.833; P<0.001). Chemotherapy could not prolong the 5-year overall survival of patients with early-stage serous and endometrioid ovarian cancer (HR, 1.092; CI, 0.954-1.249; P=0.201). These results demonstrated that adjuvant chemotherapy was unnecessary for patients with early-stage serous and endometrioid ovarian cancer after they underwent comprehensive staging surgery.

Docetaxel and cisplatin combination chemotherapy for advanced epithelial ovarian cancer with bulky residual disease

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15030-15030
Author(s):  
A. Shaharyar ◽  
K. Shabbir ◽  
M. Hafeez ◽  
Z. Alauddin ◽  
E. U. Rehman
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Combination Chemotherapy ◽  
Residual Disease ◽  
Sensory Neuropathy ◽  
Figo Stage ◽  
Hepatic Function ◽  
Co Morbidity ◽  
Patients With Diabetes ◽  
Grade 3

15030 Background: The combination of docetaxel and cisplatin as an alternative to the gold standard carboplatin and paclitaxel chemotherapy has not been explored in our patients. Docetaxel is more potent of the taxanes, therefore, this combination might yield a better outcome. This phase II study was designed to evaluate the efficacy and toxicity of docetaxel and cisplatin combination in epithelial ovarian cancer with bulky residual disease. Methods: Thirty-two new patients were enrolled between November 2003 and August 2005. Eligible patients had histopatholgically confirmed epithelial ovarian cancer, were older than 18 years and had FIGO stage IIC-IV cancer with bulky residual disease after primary cytoreductive surgery. Patients had a KPS >70 with adequate marrow and hepatic function. Patients with creatinine clearance by Cockroft-Gault formula of >60 ml/min were included. Written informed consent was obtained. Patients with diabetes mellitus, peripheral neuropathy, or cardiac co morbidity were excluded. Docetaxel and cisplatin were given at a dose of 75 mg/m2 each on day-1 of a 21-day cycle. Dexamethasone 8 mg was given thrice before and thrice after and tropisetron 5mg was given one hour before and 12 hours after chemotherapy. Docetaxel was given in 250 ml of NaCl in one-hour followed by cisplatin 75 mg/m2 in 1L of NaCl in 3 hours with pre and post hydration. NCI toxicity criteria version 2.0 and RECIST was used for evaluation. Results: Thirty patients were evaluable for response and toxicity. Final evaluation revealed CR in 12 (40%) (95% CI, 22.7–59.4%), PR in 14 (46.6%) with an ORR of 86.6% (95% CI, 69.3–96.2%). Three (10%) had SD and 1 (3.33) had PD. Grade 2 toxicity included alopecia 18 (60%), vomiting 6 (20%), diarrhea 7 (23.3%) and stomatitis in 5 (16%). Grade 3 and 4 neutropenia were seen in 12 (40%) and 9 (30%) respectively. Sensory neuropathy of grade 1 and 2 was seen in 4 (13.3%) and 2 (6.7%) respectively. Conclusion: Docetaxel and cisplatin combination chemotherapy is an effective and safe regimen in epithelial ovarian cancer with bulky residual disease. It gives a high overall response rate and has a manageable toxicity profile. No significant financial relationships to disclose.

scholarly journals Methods and conditions of fertility preservation in early-stage ovarian tumors

2013 ◽  
Vol 154 (14) ◽  
pp. 523-530
Author(s):  
Erzsébet Szatmári ◽  
Szabolcs Máté ◽  
Norbert Sipos ◽  
András Szánthó ◽  
Mihály Silhavy ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Fertility Preservation ◽  
Early Stage ◽  
Ovarian Tumors ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Stage Ia ◽  
Grade 3

The aim of this study is to review the literature of fertility-sparing techniques and their safety in early-stage malignant ovarian tumors, especially in epithelial ovarian cancer. Fertility preservation is widely accepted in early-stage borderline, germ cell and sex cord-stromal tumors. Based on data from retrospective studies, fertility-sparing surgery in epithelial ovarian cancer can be recommended in stage IA, grade 1–2 and favorable hystologic type ovarian cancer. Above stage IA, or in grade 3, or in clear-cell tumors decision making process about fertility-sparing surgery should be individual. Correct surgical staging is mandatory and oncologic safety should be primary. In the group of carefully selected patients oncological outcomes are identical to those of radical surgery. Spontaneous pregnancy rates vary, but they are generally high. Adequate counseling with patients, detailed documentation and careful follow-up is of outstanding importance. In order to improve the quality of fertility preservation techniques, establishment of treatment centers is recommended. Orv. Hetil., 2013, 154, 523–530.

scholarly journals Whole abdomen irradiation in epithelial ovarian cancer: A single institution study

2009 ◽  
Vol 17 (3-4) ◽  
pp. 51-55
Author(s):  
Lilia Gocheva ◽  
Bojidar Slavchev
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
Epithelial Ovarian Cancer ◽  
Residual Disease ◽  
Hematological Toxicity ◽  
Second Primary ◽  
Second Primary Malignancy ◽  
Platinum Based Chemotherapy ◽  
Grade 3

Background: The examination of the use of whole abdomen irradiation open field technique in optimally debulked patients with no residual disease with epithelial ovarian cancer (OC). Methods: Between 1993 and 2007, 20 patients with optimally cytoreduced epithelial OC were treated with WAI. The stage distribution was stage I in 15 patients, stage II in 1, and stage III in 4. The grade distribution was grade 1 in 10 patients, grade 2 in 4, and grade 3 in 6. WAI consisted of 30 Gy, delivered in daily fractions, mainly of 1.5 Gy (95%), 5 days/weekly, in 14 patients. After abdominal irradiation, in 75% of the patients a pelvic boost, and in 7 a boost to other risk sites was given to reach 45 - 50 Gy. Nine patients received platinum based chemotherapy (CT). Median follow-up was 7.96 years. Results: The overall survival (OS) rate was 82% and 70% at 5 and 10 years. A tendency to better survival was found in patients with age ? 40 than in those with > 40 years (100%:100% vs. 68%:51%; p=0.03). Patients with grade 1-2 tumors had significantly better 5- and 10-year survival rate than those with grade 3 tumors (100%:100% vs. 40%:20%; p<0.00). The 5- and 10-year OS for the patients 'with' and 'without' a pelvic boost turned to be in favor of the patients 'with' the boost (91%:91% vs. 60%:40%; p=0.02). In 15 patients (75%) RT was transiently interrupted because of acute gastrointestinal and hematological toxicity. Neither grade 4 acute complications nor was mortality observed. Late gastrointestinal effect developed in 1 patient, presented with grade 4 complications. The development of second primary malignancy was not observed during the follow-up period. Conclusion: WAI achieves a quite favorable 5- and 10-year survival rate with an acceptable risk of acute and late side effects in properly selected patients with epithelial OC.

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