Prognostic impact of debulking surgery and residual tumor in patients with epithelial ovarian cancer FIGO stage IV
| Autor: | Andreas du Bois, Sonia Prader, Philipp Harter, Alexander Traut, Florian Heitz, Beyhan Ataseven, C. Grimm |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Palliative care Neoplasm Residual Carcinoma Ovarian Epithelial Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Tumor stage Ascites Overall survival Medicine Humans In patient Epithelial ovarian cancer Neoplasms Glandular and Epithelial Aged Neoplasm Staging Aged 80 and over Ovarian Neoplasms 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Middle Aged Debulking Prognosis Survival Analysis Surgery Treatment Outcome Oncology 030220 oncology & carcinogenesis Female medicine.symptom business Stage iv |
| Zdroj: | Gynecologic oncology. 140(2) |
| ISSN: | 1095-6859 |
| Popis: | To determine the impact of debulking surgery (DS) and residual disease (RD) on outcome in patients with FIGO stage IV epithelial ovarian cancer (EOC).This exploratory study included 326 consecutive patients with FIGO IV EOC treated in our centers from 2000 to 2014. Data were extracted from our prospectively maintained registry.In patients, who underwent DS (n=286; 87.7%), complete macroscopic resection was achieved in 54.9% (RD0; n=157), RD of 1-10mm in 30.8% (RD1-10; n=88), and RD of10mm in 14.3% (RD10, n=41). Forty patients without surgery (NoCS; 12.3%) underwent either primary chemotherapy or palliative care only. Median overall survival (OS) in NoCS was 19months compared to 16, 25, and 50months in RD10, RD1-10, and RD0, respectively (p0.001). Multivariate analysis confirmed an inferior OS for NoCS (HR 2.51, 95% CI 1.25-3.57; p=0.001), RD10 (HR 2.17, 95% CI 1.43-3.70; p=0.002), and RD1-10 (HR 1.50, 95% CI 1.01-2.23; p=0.046) when compared with RD0. Additional independent prognostic factors were poor performance status, ascites500mL, and advanced intraabdominal tumor stage.Our results confirm the prognostic impact of optimal DS in FIGO stage IV disease. Survival benefit was greatest for patients with complete resection. Although not to the same extent patients do benefit from DS with RD≤10mm. Of note, patients with RD10mm after DS seemed not to profit from surgery showing comparable OS to patients without DS. Selecting patients who benefit from DS is as crucial in stage IV EOC patients as it is in any other patients with advanced EOC. |
| Databáze: | OpenAIRE |
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