Prognostic significance of residual tumor in patients with epithelial ovarian carcinoma stage IV in a 20 year perspective.
| Autor: | Elstrand MB; Department of Obstetrics and Gynecology, Baerum Hospital, Norway., Sandstad B, Oksefjell H, Davidson B, Tropé CG |
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| Jazyk: | angličtina |
| Zdroj: | Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2012 Mar; Vol. 91 (3), pp. 308-17. Date of Electronic Publication: 2012 Jan 09. |
| DOI: | 10.1111/j.1600-0412.2011.01316.x |
| Abstrakt: | Objective: We aimed to evaluate prognostic factors impacting on overall survival during a 20 year period with substantial changes in surgical approach and chemotherapy management of patients with epithelial ovarian carcinoma stage IV. Design: A retrospective population-based study. Setting: The Norwegian Radium Hospital during 1985-2005. Population: Three hundred and ninety-four patients with epithelial ovarian carcinoma stage IV treated at the Norwegian Radium Hospital. Methods: The cohort was divided into two groups (1985-1995 and 1996-2005), and clinical and pathological characteristics were compared. Univariate and multivariate analyses were performed to identify prognostic factors during 1985-1995, 1996-2005 and 1985-2005. Main Outcome Measures: Prognostic factors and overall survival in the three periods. Results: Median overall survival improved from 1985-1995 to 1996-2005 (from 1.3 to 2.1 years). More patients had macroscopic radical surgery (28 vs. 11%), received neoadjuvant chemotherapy and were treated with platinum-taxane combination therapy from 1996-2005 compared to 1985-1995. Patients with primary surgery had improved median overall survival from 1996-2005 compared to 1985-1995. In multivariate analyses, surgical approach was not a prognostic factor for overall survival, but chemotherapy was during 1985-2005. Postoperative residual tumor was a prognostic factor for overall survival in all periods. Conclusions: Macroscopic radical surgery is a strong prognostic factor for overall survival and is achievable in a subset of patients with epithelial ovarian carcinoma stage IV. Improved selection criteria for what treatment algorithm to choose for patients with epithelial ovarian carcinoma stage IV are warranted. (© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.) |
| Databáze: | MEDLINE |
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