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Title: | Outcome of Epithelial Ovarian Cancer Time for Strategy Trials to Resolve the Problem of Optimal Timing of Surgery | Authors: | Van de Putte, Gregg OBEN, Jolien PRENEN, Leen Schobbens, Jean Christophe Vlasselaer, Jos Van Holsbeke, Caroline DEBROCK, Guy Van Eycken, Peter DE JONGE, Eric |
Issue Date: | 2015 | Publisher: | LIPPINCOTT WILLIAMS & WILKINS | Source: | INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 25 (6), p. 993-999 | Abstract: | Introduction The standard treatment of ovarian cancer is the combination of debulking surgery and chemotherapy. There is an ongoing discussion on which treatment is best: primary debulking surgery (PDS) or neoadjuvant chemotherapy with interval debulking (NACT-IDS). Even a large randomized trial has not settled this issue. We examined whether comparing a specified treatment protocol would not be a more logical approach to answer this type of discussions. Methods A retrospective study of 142 consecutively treated patients according to a fixed protocol between 2000 and 2012 was conducted. Disease-free survival and overall survival were calculated by univariate and multivariate analyses for the whole group and for advanced stages separately. Specific differences between PDS and NACT-IDS were studied. Comparison of results from large databases was made. Results Disease-free survival and overall 5-year survival for the whole group were 35% and 50%. For the advanced stages, disease-free survival and overall 5-year survival were 14% and 36%, with a median disease-free and overall survival of 16 and 44 months. Of the 98 women with advanced ovarian carcinoma, 54% of operable patients underwent PDS and 44% underwent NACT-IDS. More patients in the PDS group were optimally (<1 cm) debulked: 80% vs 71%. There was no significant difference in survival between PDS or NACT-IDS. Optimally debulked patients had a significant better overall survival in multivariate analysis with a hazard ratio of 2.1. Discussion Outcome of treatment according to a fixed protocol with a mixture of PDS and NACT-IDS was similar to results from large databases. We hypothesize that comparison of a specific strategy may yield more useful results than awaiting the perfect randomized trial. | Notes: | [Van de Putte, Gregg; Oben, Jolien; Schobbens, Jean Christophe; Vlasselaer, Jos; Van Holsbeke, Caroline; de Jonge, Eric] Ziekenhuis Oost Limburg, Dept Gynecol, Genk, Belgium. [Prenen, Leen] Univ Hasselt, Interuniv Inst Biostat & Stat Bioinformat, Diepenbeek, Belgium. [Debrock, Guy] Ziekenhuis Oost Limburg, Dept Oncol, Genk, Belgium. [Van Eycken, Peter] Ziekenhuis Oost Limburg, Dept Pathol, Genk, Belgium. | Keywords: | ovarian carcinoma; surgery; neoadjuvant chemotherapy; survival; strategy;Ovarian carcinoma; Surgery; Neoadjuvant chemotherapy; Survival; Strategy | Document URI: | http://hdl.handle.net/1942/19135 | ISSN: | 1048-891X | e-ISSN: | 1525-1438 | DOI: | 10.1097/IGC.0000000000000461 | ISI #: | 000357286900008 | Rights: | © 2015 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2016 |
Appears in Collections: | Research publications |
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