Document Detail

Treatment of FIGO stage IV ovarian carcinoma: results of primary surgery or interval surgery after neoadjuvant chemotherapy: a retrospective study.
MedLine Citation:
PMID:  17367318     Owner:  NLM     Status:  MEDLINE    
The objective of the study is to determine whether surgery influences the outcome of stage IV ovarian cancer. The study design is as follows: From May 1995 to December 2000, 129 patients with FIGO stage IV ovarian cancer, recruited in 42 centers, were prospectively included in GINECO first-line randomized studies of platinum-based regimens with paclitaxel administered simultaneously or sequentially. In all, 109 were eligible for this study. Standard peritoneal cytoreductive surgery was defined as a procedure including at least total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and peritoneal debulking. Surgery was considered optimal if residual lesions were smaller than 1 cm. The Kaplan-Meier method was used to compare survival. Initial abdominopelvic cytoreductive surgery was considered standard in 55 (54%) patients. Abdominopelvic surgery was optimal in 29 patients and nonoptimal in 26. Twenty-two (22%) patients had a simple biopsy, and 25 (24%) patients underwent substandard surgery. Twenty-two of these 47 patients without initial standard surgery underwent a second surgical procedure, and 17 of the 22 patients completed standard surgery. The median overall survival time in the entire population was 24.3 months (95% confidence interval [CI], 19.5-29.1 months). Patients treated without a cytoreductive surgical procedure had significantly worse median survival (15.1 months; 95% CI, 5.4-24.9 months) than patients who had optimal primary surgery (22.9 months; 95% CI, 15.6-30.1 months), nonoptimal primary surgery (27.1 months; 95% CI, 21.2-32.9 months), or neoadjuvant chemotherapy followed by surgery (45.5 months; 95% CI, 23.5-67.5 months) (P= .001). In conclusion, this study shows a significant benefit of debulking surgery in stage IV ovarian cancer patients who responded to neoadjuvant chemotherapy. Neoadjuvant chemotherapy can help to select patients for surgery.
A Rafii; B Deval; J-F Geay; N Chopin; X Paoletti; D Paraiso; E Pujade-Lauraine
Related Documents :
20018318 - Multivariate analysis of risk factors for long-term urethroplasty outcome.
12829198 - Outcomes of osteomyelitis among patients treated with outpatient parenteral antimicrobi...
15565568 - Randomized trial of leuprorelin and flutamide in male patients with hepatocellular carc...
18381138 - Statins are independently associated with reduced mortality in patients undergoing infr...
22970988 - Postoperative phosphodiesterase type 5 inhibitor administration increases the rate of u...
21631708 - Indication, management, and outcome of brachycephalic dogs requiring mechanical ventila...
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-03-15
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  17     ISSN:  1048-891X     ISO Abbreviation:  Int. J. Gynecol. Cancer     Publication Date:    2007 Jul-Aug
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  777-83     Citation Subset:  IM    
Service de Chirurgie, Institut Claudius Regaud, Toulouse, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Disease Progression
Disease-Free Survival
Epithelial Cells / pathology
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Ovarian Neoplasms / drug therapy*,  pathology,  surgery*
Retrospective Studies

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

Previous Document:  Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for...
Next Document:  The prognostic value of pretreatment 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography s...