Document Detail


Cytoreductive surgery for stage IV epithelial ovarian cancer.
MedLine Citation:
PMID:  10746968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We tried to determine the role of cytoreductive surgery for stage IV epithelial ovarian cancer and in what conditions this surgical procedure could carry the best benefits. From January 1986 to December 1997, seventy-one of 73 patients with stage IV epithelial ovarian cancer who were treated in Cancer Hospital of Shanghai Medical University were retrospectively reviewed. Clinical information including age, grade, histology, presence of ascites, size of residual disease, site of extra-abdominal metastasis, whether initially presenting as metastatic disease or not, neo-adjuvant chemotherapy, platinum-based chemotherapy and second-line chemotherapy was obtained. Survival was calculated by life-table and survival curves were computed using the Kaplan-Meier method with differences in survival estimated by log-rank test. Independent prognostic factors were identified by Cox's proportional hazards regression model. The median age of the patients' population was 54 years (range 22-82), median follow-up time was 12 months (range 3 to 130) and estimated 5-year survival rate 6.1%. Thirty out of 71 (42.3%) patients were successfully debulked (< or = 1 cm) at the time of initial surgery. There was a significant difference in five-year survival rate between patients optimally (14.1%) vs suboptimally (0%) cytoreduced, with an estimated median survival in the optimal group of 23 months vs 9 months in the suboptimal group (P=0.0001, long-rank test). When the variables were factorized, only in patients with malignant pleural effusion or positive supraclavicular lymph nodes, optimal cytoreduction could get the greatest benefits. Multivariate analysis revealed that the size of residual disease and ascites were independent factors of survival. However, only ascites was the prognostic factor of progression-free survival. Optimal cytoreductive surgery is an important determinant of survival in women with stage IV epithelial ovarian cancer, mainly in those with malignant pleural effusion or positive supraclavicular lymph node pathology.
Authors:
R Y Zang; Z Y Zhang; S M Cai; Z T Li; J Chen; M Q Tang; Q Liu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of experimental & clinical cancer research : CR     Volume:  18     ISSN:  0392-9078     ISO Abbreviation:  J. Exp. Clin. Cancer Res.     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-05-15     Completed Date:  2000-05-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8308647     Medline TA:  J Exp Clin Cancer Res     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  449-54     Citation Subset:  IM    
Affiliation:
Dept. of Gynaecological Oncology, Cancer Hospital, Shanghai Medical University, People's Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ascites
Carcinoma / mortality,  pathology,  surgery*
Female
Follow-Up Studies
Humans
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Ovarian Neoplasms / mortality,  pathology,  surgery*
Proportional Hazards Models
Retrospective Studies
Survival Rate
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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