Histopathology predicts clinical outcome in advanced epithelial ovarian cancer patients treated with neoadjuvant chemotherapy and debulking surgery
| Autor: | Ryuichiro Nishimura, Miho Muraji, Kiyoshi Fujiwara, Satoshi Yamaguchi, Senn Wakahashi, Sayaka Ueno, Tamotsu Sudo, Shin-ichi Iwasaki |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Neoplasm Residual Paclitaxel medicine.medical_treatment Carcinoma Ovarian Epithelial Disease-Free Survival Carboplatin chemistry.chemical_compound Predictive Value of Tests Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Neoplasms Glandular and Epithelial Peritoneal Neoplasms Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Ovarian Neoplasms Chemotherapy Proportional hazards model business.industry Hazard ratio Obstetrics and Gynecology Odds ratio Middle Aged Debulking Neoadjuvant Therapy Surgery Treatment Outcome chemistry Chemotherapy Adjuvant Drug Resistance Neoplasm Female Histopathology Neoplasm Grading business |
| Zdroj: | Gynecologic Oncology. 131:531-534 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2013.09.030 |
| Popis: | Objective To analyze the factors prognostic of survival in patients with advanced epithelial ovarian cancer (EOC) treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery. Methods Outcomes were retrospectively in patients with advanced EOC or peritoneal cancer who received neoadjuvant paclitaxel and carboplatin chemotherapy every 3weeks for three to four cycles, followed by interval debulking surgery and three additional cycles of the same regimens from January 2001 to November 2010. Therapeutic response was assessed histopathologically as grade 0 to 3, based on the degree of disappearance of cancer cells, displacement by necrotic and fibrotic tissue, and tumor-induced inflammation. Factors prognostic of progression-free survival (PFS) and overall survival (OS) were calculated. Results The 124 enrolled patients had a median age of 62years (range, 35–79years). Viable cancer cells were observed in specimens resected from 72 patients (58%) at interval debulking surgery after NAC. Multivariate analysis using the Cox proportional hazard model showed that advanced (stage IV) disease (hazard ratio [HR]=1.94, p =0.003), residual cancer at the end of surgery ≥1cm (HR=3.78, p p =0.03) were independent predictors of decreased OS. Grade 0–1 was also an independent predictor of increased risk of relapse within 6months (odds ratio=8.42, p =0.003). Conclusions Residual disease of ≥1cm, advanced stage, and the presence of more viable disease in resected specimens are prognostic factors for survival in advanced EOC patients receiving NAC followed by interval debulking surgery. |
| Databáze: | OpenAIRE |
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