Cancer of the ovary, fallopian tube and peritoneum: surgical management
| Autor: | Damir Danolić, Ilija Alvir, Ivica Mamić, Lucija Kostić, Darko Tomica, Marko Puljiz, Mario Puljiz |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Libri Oncologici : Croatian Journal of Oncology Volume 43 Issue 1-3 |
| ISSN: | 2584-3826 0300-8142 |
| Popis: | Surgery is the cornerstone of eff ective management of the ovarian, tubal and peritoneal cancer. In 2014 the International Federation of Gynecology and Obstetrics (FIGO) published a new classifi cation collectively covering cancer of ovary, fallopian tube and peritoneum as well as malignant ovarian germ cell tumors and malignant sex-cord stromal tumors. Comprehensive surgical staging according to the 2014 FIGO classifi cation system plays an important role in management of apparently early stage of ovarian, tubal and peritoneal cancer. Primary debulking (cytoreductive) surgery followed by paclitaxel and platinum based combination chemotherapy is the cornerstone of the advanced-stage disease treatment. In cases of suboptimal primary cytoreduction, interval debulking surgery performed after two to four cycles of chemotherapy based on the clinical judgment of the gynecologic oncologist is second att empt to achieve optimal cytoreduction. Secondary cytoreductive surgery can be considered in patients with platinum-sensitive locally recurrent ovarian cancer. The volume of residual tumor remaining after these surgical approaches is one of the most important independent prognostic factors for survival. Kirurško liječenje je temelj uspješnog liječenja raka jajnika, jajovoda i potrbušnice. Međunarodno federacija ginekologa i opstetričara (FIGO) u 2014. godini objavila je novu klasifi kaciju koja zajedno obuhvaća rak jajnika, jajovoda, potrbušnice, zloćudne tumore zametnih stanica i zloćudne tumore specijalizirane strome jajnika. Kirurško stupnjevanje bolesti prema FIGO 2014 klasifi kaciji je ključno u liječenju raka jajnika, jajovoda i potrbušnice naizgled ranog stadija bolesti. Primarna citoredukcijska kirurgija i dodatno liječenje kemoterapijom je standardni pristup uznapredovaloj bolesti. Prilikom suboptimalne citoredukcije tijekom primarnog kirurškog zahvata “interval debulking surgery” nakon drugog do četvrtog ciklusa kemoterapije, ovisno o procjeni ginekološkog onkologa, drugi je pokušaj postizanja optimalne ciotredukcije. Sekundarna citoredukcijska kirurgija dolazi u obzir kod pacijentica koje su osjetljive na kemoterapiju, a imaju lokalni povrat bolesti. Veličina rezidualnog tumorskog tkiva nakon kirurških zahvata je najznačajniji prognostički čimbenik na koji se može utjecati tijekom liječenja. |
| Databáze: | OpenAIRE |
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