Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer

Autor: Harter, Philipp, Sehouli, Jalid, Vergote, Ignace, Ferron, Gwenael, Reuss, Alexander, Meier, Werner, Greggi, Stefano, Mosgard, Berit J, Selle, Frederic, Guyon, Frédéric, Pomel, Christophe, Lécuru, Fabrice, Zang, Rongyu, Avall-Lundqvist, Elisabeth, Kim, Jae-Weon, Ponce, Jordi, Raspagliesi, Francesco, Kristensen, Gunnar, Classe, Jean-Marc, Hillemanns, Peter, Jensen, Pernille, Hasenburg, Annette, Ghaem-Maghami, Sadaf, Mirza, Mansoor R, Lund, Bente, Reinthaller, Alexander, Santaballa, Ana, Olaitan, Adeola, Hilpert, Felix, du Bois, Andreas, S Buchholz, A Burges, U Canzler, D Denschlag, A El-Balat, G Emons, R Felberbaum, N de Gregorio, M Gropp-Meier, V Hanf, L Hanker, R Hils, C Kurzeder, B Lampe, A Mustea, M Schmidt, R Schutz, M Weigel, S Weiser, A Zorr, C Marth, E Petru, T Scholl, M Beltran, I Bover, A Gomez di Laino, N Lainez, S Martinez, A Poveda Velasco, M Romeo, H Crouet, E de Gournay, G Deplanque, P Follana, A Floquet, D Lanvin, J Leveque, E Pujade-Lauraine, N Raban, B Resch, A M Savoye, G Aletti, G Giorda, F Landoni, C Scaffa, J Abu, F Alexander-Sefre, D Barton, S Butler-Manuel, R Clayton, R Crawford, T Duncan, A El-Ghobashy, C Fotopoulou, M Hall, C Intrivici, A Lawrence, D Luesley, R Naik, A Nordin, J Tidy, L Fokdahl, A Hofsjö, P Kjolhede, B Eyjolfsdottir, Z Y Dai, P Zhang, B Aminossadati, M Hahmann, C Nasemann, S Yahiaoui, M Wittenberg, C Schade-Brittinger, G Elser, D Reddig, M Kuncke, S Polleis, Y Mattukat, A Riha, R Berger, J de Roover, B Kaur, J Crook, F Nepote, B Votan, M Andriamamonjy, J Bryce, S Ristinge
Přispěvatelé: Philipp, H, Jalid, S, Ignace, V, Gwenael, F, Alexander, R, Werner, M, Stefano, G, Berit J, M, Frederic, S, Frédéric, G, Christophe, P, Fabrice, L, Rongyu, Z, Elisabeth, A, Jae-Weon, K, Jordi, P, Francesco, R, Gunnar, K, Jean-Marc, C, Peter, H, Pernille, J, Annette, H, Sadaf, G, Mansoor R, M, Bente, L, Ana, S, Adeola, O, Felix, H, Andreas, D, Buchholz, S, Burges, A, Canzler, U, Denschlag, D, El-Balat, A, Emons, G, Felberbaum, R, de Gregorio, N, Gropp-Meier, M, Hanf, V, Hanker, L, Hils, R, Kurzeder, C, Lampe, B, Mustea, A, Schmidt, M, Schutz, R, Weigel, M, Weiser, S, Zorr, A, Marth, C, Petru, E, Scholl, T, Beltran, M, Bover, I, Gomez di Laino, A, Lainez, N, Martinez, S, Poveda Velasco, A, Romeo, M, Crouet, H, de Gournay, E, Deplanque, G, Follana, P, Floquet, A, Lanvin, D, Leveque, J, Pujade-Lauraine, E, Raban, N, Resch, B, M Savoye, A, Aletti, G, Giorda, G, Landoni, F, Scaffa, C, Abu, J, Alexander-Sefre, F, Barton, D, Butler-Manuel, S, Clayton, R, Crawford, R, Duncan, T, El-Ghobashy, A, Fotopoulou, C, Hall, M, Intrivici, C, Lawrence, A, Luesley, D, Naik, R, Nordin, A, Tidy, J, Fokdahl, L, Hofsjö, A, Kjolhede, P, Eyjolfsdottir, B, Y Dai, Z, Zhang, P, Aminossadati, B, Hahmann, M, Nasemann, C, Yahiaoui, S, Wittenberg, M, Schade-Brittinger, C, Elser, G, Reddig, D, Kuncke, M, Polleis, S, Mattukat, Y, Riha, A, Berger, R, de Roover, J, Kaur, B, Crook, J, Nepote, F, Votan, B, Andriamamonjy, M, Bryce, J, Ristinge, S
Jazyk: angličtina
Rok vydání: 2021
Předmět:
EPITHELIAL OVARIAN
Oncology
medicine.medical_specialty
BEVACIZUMAB
MULTICENTER
Antineoplastic Agents
PACLITAXEL
Systemic therapy
law.invention
Antineoplastic Agent
Randomized controlled trial
law
Internal medicine
Humans
Medicine
RECURRENT
Proportional Hazards Models
Aged
Ovarian Neoplasms
SECONDARY CYTOREDUCTION
business.industry
Ovarian Neoplasm
Antineoplastic Agents/therapeutic use
Obstetrics and Gynecology
Ovarian Neoplasms/drug therapy
Cytoreduction Surgical Procedures
General Medicine
CHEMOTHERAPY
Middle Aged
OPEN-LABEL
medicine.disease
Survival Analysis
Combined Modality Therapy
Neoplasm Recurrence
Local/drug therapy
Recurrent Ovarian Cancer
Proportional Hazards Model
Quality of Life
Female
Survival Analysi
Neoplasm Recurrence
Local
business
Cytoreductive surgery
Ovarian cancer
Human
Zdroj: Harter, P, Sehouli, J, Vergote, I, Ferron, G, Reuss, A, Meier, W, Greggi, S, Mosgard, B J, Selle, F, Guyon, F, Pomel, C, Lécuru, F, Zang, R, Avall-Lundqvist, E, Kim, J-W, Ponce, J, Raspagliesi, F, Kristensen, G, Classe, J-M, Hillemanns, P, Jensen, P, Hasenburg, A, Ghaem-Maghami, S, Mirza, M R, Lund, B, Reinthaller, A, Santaballa, A, Olaitan, A, Hilpert, F, du Bois, A & DESKTOP III Investigators 2021, ' Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer ', The New England Journal of Medicine, vol. 385, no. 23, pp. 2123-2131 . https://doi.org/10.1056/NEJMoa2103294
NEW ENGLAND JOURNAL OF MEDICINE
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
Harter, P, Sehouli, J, Vergote, I, Ferron, G, Reuss, A, Meier, W, Greggi, S, Mosgard, B J, Selle, F, Guyon, F, Pomel, C, Lécuru, F, Zang, R, Avall-Lundqvist, E, Kim, J W, Ponce, J, Raspagliesi, F, Kristensen, G, Classe, J M, Hillemanns, P, Jensen, P, Hasenburg, A, Ghaem-Maghami, S, Mirza, M R, Lund, B, Reinthaller, A, Santaballa, A, Olaitan, A, Hilpert, F & Du Bois, A 2021, ' Randomized trial of cytoreductive surgery for relapsed ovarian cancer ', New England Journal of Medicine, vol. 385, no. 23, pp. 2123-2131 . https://doi.org/10.1056/NEJMoa2103294
ISSN: 0028-4793
DOI: 10.1056/NEJMoa2103294
Popis: BACKGROUND: Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. METHODS: We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. RESULTS: A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. CONCLUSIONS: In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. (Funded by the AGO Study Group and others; DESKTOP III ClinicalTrials.gov number, NCT01166737.).
Databáze: OpenAIRE
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