Secondary cytoreduction in recurrent ovarian cancer- experience from a tertiary care centre in India

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY
Priya Bhati, Anitha Thomas, Rachel George Chandy, Amrita Datta, Dhanya Susan Thomas, Vinotha Thomas, Abraham Peedicayil, Ajit Sebastian
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引用次数: 0

Abstract

Introduction

Ovarian cancer is a disease that presents in advanced stage, due to the absence of any specific or overtly dramatic symptoms. The standard of care is primary debulking surgery, followed by chemotherapy. Ovarian cancer recurrence treatment is very challenging and there is always a debate between cytoreduction vs chemotherapy.

Methods

The electronic medical records of all patients who underwent secondary cytoreductive surgery for recurrent ovarian cancer between January 2011 and December 2019 were retrieved the patients with platinum sensitive recurrent ovarian cancer who underwent secondary cytoreductive surgery in our department during this time period were included.

Results

A total of 52 patients underwent secondary cytoreductive surgery for recurrent ovarian cancer during the study period. Median treatment free interval after primary treatment was 20 months (range 6–132). The secondary cytoreductive surgery was highly complex in 4(8 %) patients,19 (37 %) had intermediate surgical complexity score, 29 (55 %) had low surgical complexity score according to the Aletti complexity score. Secondary cytoreductive surgery was complete (no macroscopic residual disease) in 31(60 %); Optimal (R1) in 17 (33 %) and suboptimal in only 4 (7 %) of the patients. Out of the 52 patients,8 expired, 16 had a second recurrence, and 10 were lost to follow up over time.

Conclusion

Successful surgery is possible in well selected patients, which in turn can lead to a meaningful progression free and overall survival benefit. Meticulous individualisation of cases should be done keeping in mind the patient’s performance status, prior treatment history & toxicity; distribution & extent of disease, and the patient’s overall life goals.

复发性卵巢癌的二次细胞减灭术--来自印度一家三级医疗中心的经验
导言卵巢癌是一种晚期疾病,由于没有任何特殊或明显的症状。标准的治疗方法是先进行清扫手术,然后进行化疗。方法 检索 2011 年 1 月至 2019 年 12 月期间所有因复发性卵巢癌接受二次囊肿剥除手术的患者的电子病历,纳入在此期间在我科接受二次囊肿剥除手术的铂敏感复发性卵巢癌患者。初次治疗后的中位无治疗间隔时间为 20 个月(6-132 个月)。根据 Aletti 复杂性评分,4(8%)名患者的二次细胞剥离手术高度复杂,19(37%)名患者的手术复杂性处于中等水平,29(55%)名患者的手术复杂性处于低水平。31(60%)例患者的二次细胞剥脱手术为完全手术(无大体残留病灶);17(33%)例患者的二次细胞剥脱手术为最佳手术(R1),仅有 4(7%)例患者的二次细胞剥脱手术为次佳手术。在 52 名患者中,8 人死亡,16 人二次复发,10 人失去随访机会。在对病例进行细致的个体化治疗时,应考虑到患者的表现状态、既往治疗史、毒性、分布情况、疾病程度以及患者的总体生活目标。
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来源期刊
Gynecologic Oncology Reports
Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-
CiteScore
2.00
自引率
0.00%
发文量
183
审稿时长
41 days
期刊介绍: Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.
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