What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study
Autor: | Robert M. Wenham, Thomas C. Krivak, Michael A. Bookman, Michael J. Goodheart, Floor J. Backes, Linda F. Carson, Michael Friedlander, A. Miller, G. Larry Maxwell, Krishnansu S. Tewari, David G. Mutch, Neil S. Horowitz, Scott D. Richard, Bunja Rungruang, Noah Rodriguez, Chad A. Hamilton |
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Rok vydání: | 2016 |
Předmět: |
Oncology
Adult Cancer Research medicine.medical_specialty medicine.medical_treatment Optimal Debulking Gynecologic oncology Carcinoma Ovarian Epithelial Article 03 medical and health sciences 0302 clinical medicine Internal medicine Odds Ratio Medicine Humans Stage IIIC Neoplasms Glandular and Epithelial Retroperitoneal Space Neoplasm Metastasis Lymph node Aged Neoplasm Staging Aged 80 and over Ovarian Neoplasms 030219 obstetrics & reproductive medicine business.industry Cancer Cytoreduction Surgical Procedures Middle Aged medicine.disease Debulking Survival Analysis medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Lymphadenectomy Female Lymph Nodes Neoplasm Grading business Ovarian cancer |
Zdroj: | Cancer. 123(6) |
ISSN: | 1097-0142 |
Popis: | The purpose of this study was to determine the effect of retroperitoneal (RP) exploration on progression-free survival (PFS) and overall survival (OS) in epithelial ovarian cancer (EOC) patients with stage IIIC disease who underwent optimal debulking surgery.Data were collected from records of the Gynecologic Oncology Group 182 (GOG-182) study of stage IIIC EOC patients cytoreduced to no gross residual disease (R0) or minimal gross residual (1 cm) disease (MGRD) at primary surgery. Patients with stage IIIC disease by intraperitoneal (IP) tumor were included and divided into 3 groups: 1) 2 cm IP tumor without lymph node involvement (IP/RP-), 2) 2 cm IP tumor with lymph node involvement (IP/RP+), and 3) 2 cm IP tumor with no RP exploration (IP/RP?). The effects of disease distribution and RP exploration on PFS and OS were assessed using Kaplan-Meier and proportional hazards methods.There were 1871 stage IIIC patients in GOG-182 who underwent optimal primary debulking surgery. Of these, 689 (36.8%) underwent RP exploration with removal of lymph nodes from at least 1 para-aortic site, and 1182 (63.2%) did not. There were 269 patients in the IP/RP- group, 420 patients in the IP/RP + group, and 1182 patients in the IP/RP? group. Improved PFS (18.5 vs 16.0 months; P .0001) and OS (53.3 vs 42.8 months; P .0001) were associated with RP exploration versus no exploration. Patients with MGRD had improved PFS (16.8 vs 15.1 months, P = 0.0108) and OS (44.9 vs 40.5 months, P = 0.0076) versus no exploration.RP exploration at the time of primary surgery in patients with optimally debulked stage IIIC EOC is associated with a survival benefit. Cancer 2017;123:985-93. © 2016 American Cancer Society. |
Databáze: | OpenAIRE |
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