Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 5/2019

01-05-2019 | Research Article

Optimization of surgical treatment of advanced ovarian cancer: a Spanish expert perspective

Authors: L. Minig, J. de Santiago, S. Domingo, A. Gil-Moreno, S. Martínez, A. Rodríguez-Garzotto, L. Chiva

Published in: Clinical and Translational Oncology | Issue 5/2019

Login to get access

Abstract

Background

Optimal upfront treatment of patients with advanced ovarian cancer is complex and requires the adequate function of a multidisciplinary team. Specific standard of quality of care needs to be taken into consideration.

Methods

A literature search in PubMed was performed using the following criteria: (“ovarian neoplasms”[MeSH Terms] OR (“ovarian”[All Fields] AND “neoplasms”[All Fields]) OR “ovarian neoplasms”[All Fields] OR (“ovarian”[All Fields] AND “cancer”[All Fields]) OR “ovarian cancer”[All Fields])“[Date - Publication]: “2018/01/14”[Date - Publication]).

Results

This article describes how to optimize the surgical management of advanced ovarian cancer, to achieve the best results in terms of survival and quality of life. For this purpose, this document will cover aspects related to pre-, intra- and postoperative care of newly diagnosed advanced ovarian cancer patients.

Conclusion

Optimizing upfront treatment of patients with advanced ovarian cancer is complex and requires a structured quality management program including the wise judgment of a multidisciplinary team. Surgeries performed by gynecologic oncologists with formal training in cytoreductive techniques at referral centers are crucial factors to obtain better clinical and oncological outcomes. However, other factors such as the patient’s clinical status, the hospital infrastructure and equipment, as well as the tumor biology of each individual patient should also be taken into account before deciding on an initial therapeutic strategy for advanced-stage ovarian cancer to offer patients the best quality of care.

Literature
  1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49(6):1374–403.View Article
  2. Lataifeh I, Marsden DE, Robertson G, Gebski V, Hacker NF. Presenting symptoms of epithelial ovarian cancer. Aust N Z J Obstet Gynaecol. 2005;45(3):211–4.View Article
  3. Querleu D, Planchamp F, Chiva L, Fotopoulou C, Barton D, Cibula D, et al. European society of gynaecologic oncology quality indicators for advanced ovarian cancer surgery. Int J Gynecol Cancer. 2016;26(7):1354–63.View Article
  4. du Bois A, Rochon J, Pfisterer J, Hoskins WJ. Variations in institutional infrastructure, physician specialization and experience, and outcome in ovarian cancer: a systematic review. Gynecol Oncol. 2009;112(2):422–36.View Article
  5. Fung-Kee-Fung M, Kennedy EB, Biagi J, Colgan T, D’Souza D, Elit LM, et al. The optimal organization of gynecologic oncology services: a systematic review. Curr Oncol. 2015;22(4):e282–93.View Article
  6. Wright AA, Bohlke K, Armstrong DK, Bookman MA, Cliby WA, Coleman RL, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline. Gynecol Oncol. 2016;143(1):3–15.View Article
  7. Verleye L, Ottevanger PB, van der Graaf W, Reed NS, Vergote I, Gynaecological Cancer Group of European Organisation for R, et al. EORTC-GCG process quality indicators for ovarian cancer surgery. Eur J Cancer. 2009;45(4):517–26.
  8. Bristow RE, Chang J, Ziogas A, Campos B, Chavez LR, Anton-Culver H. Sociodemographic disparities in advanced ovarian cancer survival and adherence to treatment guidelines. Obstet Gynecol. 2015;125(4):833–42.View Article
  9. Chi DS, Zivanovic O, Levinson KL, Kolev V, Huh J, Dottino J, et al. The incidence of major complications after the performance of extensive upper abdominal surgical procedures during primary cytoreduction of advanced ovarian, tubal, and peritoneal carcinomas. Gynecol Oncol. 2010;119(1):38–42.View Article
  10. Fagotti A, Ferrandina G, Vizzielli G, Fanfani F, Gallotta V, Chiantera V, et al. Phase III randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load (SCORPION trial): final analysis of peri-operative outcome. Eur J Cancer. 2016;59:22–33.View Article
  11. Thrall MM, Goff BA, Symons RG, Flum DR, Gray HJ. Thirty-day mortality after primary cytoreductive surgery for advanced ovarian cancer in the elderly. Obstet Gynecol. 2011;118(3):537–47.View Article
  12. Aletti GD, Eisenhauer EL, Santillan A, Axtell A, Aletti G, Holschneider C, et al. Identification of patient groups at highest risk from traditional approach to ovarian cancer treatment. Gynecol Oncol. 2011;120(1):23–8.View Article
  13. du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer. 2009;115(6):1234–44.View Article
  14. Winter WE 3rd, Maxwell GL, Tian C, Carlson JW, Ozols RF, Rose PG, et al. Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol. 2007;25(24):3621–7.View Article
  15. Sorensen SS, Mosgaard BJ. Combination of cancer antigen 125 and carcinoembryonic antigen can improve ovarian cancer diagnosis. Dan Med Bull. 2011;58(11):A4331.PubMed
  16. Borley J, Wilhelm-Benartzi C, Yazbek J, Williamson R, Bharwani N, Stewart V, et al. Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer. BJOG. 2015;122(6):843–9.View Article
  17. Ferrandina G, Sallustio G, Fagotti A, Vizzielli G, Paglia A, Cucci E, et al. Role of CT scan-based and clinical evaluation in the preoperative prediction of optimal cytoreduction in advanced ovarian cancer: a prospective trial. Br J Cancer. 2009;101(7):1066–73.View Article
  18. Rutten MJ, van de Vrie R, Bruining A, Spijkerboer AM, Mol BW, Kenter GG, et al. Predicting surgical outcome in patients with International Federation of Gynecology and Obstetrics stage III or IV ovarian cancer using computed tomography: a systematic review of prediction models. Int J Gynecol Cancer. 2015;25(3):407–15.View Article
  19. Suppiah S, Chang WL, Hassan HA, Kaewput C, Asri AAA, Saad FFA, et al. Systematic review on the accuracy of positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging in the management of ovarian cancer: is functional information really needed? World J Nucl Med. 2017;16(3):176–85.View Article
  20. Low RN, Barone RM. Combined diffusion-weighted and gadolinium-enhanced MRI can accurately predict the peritoneal cancer index preoperatively in patients being considered for cytoreductive surgical procedures. Ann Surg Oncol. 2012;19(5):1394–401.View Article
  21. Espada M, Garcia-Flores JR, Jimenez M, Alvarez-Moreno E, De Haro M, Gonzalez-Cortijo L, et al. Diffusion-weighted magnetic resonance imaging evaluation of intra-abdominal sites of implants to predict likelihood of suboptimal cytoreductive surgery in patients with ovarian carcinoma. Eur Radiol. 2013;23(9):2636–42.View Article
  22. Michielsen K, Vergote I, Op de Beeck K, Amant F, Leunen K, Moerman P, et al. Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT. Eur Radiol. 2014;24(4):889–901.
  23. Di Guilmi J, Salvo G, Mehran R, Sood AK, Coleman RL, Lu KH, et al. Role of video-assisted thoracoscopy in advanced ovarian cancer: a literature review. Int J Gynecol Cancer. 2016;26(4):801–6.View Article
  24. Deffieux X, Castaigne D, Pomel C. Role of laparoscopy to evaluate candidates for complete cytoreduction in advanced stages of epithelial ovarian cancer. Int J Gynecol Cancer. 2006;16(Suppl 1):35–40.View Article
  25. Fagotti A, Vizzielli G, De Iaco P, Surico D, Buda A, Mandato VD, et al. A multicentric trial (Olympia-MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer. Am J Obstet Gynecol. 2013;209(5):462 e1–e11.
  26. Rutten MJ, van Meurs HS, van de Vrie R, Gaarenstroom KN, Naaktgeboren CA, van Gorp T, et al. Laparoscopy to predict the result of primary cytoreductive surgery in patients with advanced ovarian cancer: a randomized controlled trial. J Clin Oncol. 2017;35(6):613–21.View Article
  27. Vergote I, du Bois A, Amant F, Heitz F, Leunen K, Harter P. Neoadjuvant chemotherapy in advanced ovarian cancer: on what do we agree and disagree? Gynecol Oncol. 2013;128(1):6–11.View Article
  28. Bristow RE, Chang J, Ziogas A, Anton-Culver H, Vieira VM. Spatial analysis of adherence to treatment guidelines for advanced-stage ovarian cancer and the impact of race and socioeconomic status. Gynecol Oncol. 2014;134(1):60–7.View Article
  29. Bristow RE, Chang J, Ziogas A, Randall LM, Anton-Culver H. High-volume ovarian cancer care: survival impact and disparities in access for advanced-stage disease. Gynecol Oncol. 2014;132(2):403–10.View Article
  30. Aune G, Torp SH, Syversen U, Hagen B, Tingulstad S. Ten years’ experience with centralized surgery of ovarian cancer in one health region in Norway. Int J Gynecol Cancer. 2012;22(2):226–31.View Article
  31. Robinson WR, Ritter J, Rogers AS, Tedjarati S, Lieberenz C. Clinical trial participation is associated with improved outcome in women with ovarian cancer. Int J Gynecol Cancer. 2009;19(1):124–8.View Article
  32. Bristow RE, Palis BE, Chi DS, Cliby WA. The National Cancer Database report on advanced-stage epithelial ovarian cancer: impact of hospital surgical case volume on overall survival and surgical treatment paradigm. Gynecol Oncol. 2010;118(3):262–7.View Article
  33. European Society of Gynaecological Oncology. ESGO Ovarian Cancer OPERATIVE REPORT. October 2016; https://​www.​esgo.​org/​wp-content/​uploads/​2016/​10/​ESGO-Operative-Report.​pdf.
  34. Marth C, Hiebl S, Oberaigner W, Winter R, Leodolter S, Sevelda P. Influence of department volume on survival for ovarian cancer: results from a prospective quality assurance program of the Austrian Association for Gynecologic Oncology. Int J Gynecol Cancer. 2009;19(1):94–102.View Article
  35. Vernooij F, Heintz AP, Witteveen PO, van der Heiden-van der Loo M, Coebergh JW, van der Graaf Y. Specialized care and survival of ovarian cancer patients in The Netherlands: nationwide cohort study. J Natl Cancer Inst. 2008;100(6):399–406.
  36. Tingulstad S, Skjeldestad FE, Hagen B. The effect of centralization of primary surgery on survival in ovarian cancer patients. Obstet Gynecol. 2003;102(3):499–505.PubMed
  37. Dahm-Kahler P, Palmqvist C, Staf C, Holmberg E, Johannesson L. Centralized primary care of advanced ovarian cancer improves complete cytoreduction and survival—a population-based cohort study. Gynecol Oncol. 2016;142(2):211–6.View Article
  38. Eggink FA, Mom CH, Kruitwagen RF, Reyners AK, Van Driel WJ, Massuger LF, et al. Improved outcomes due to changes in organization of care for patients with ovarian cancer in the Netherlands. Gynecol Oncol. 2016;141(3):524–30.View Article
  39. Greving JP, Vernooij F, Heintz AP, van der Graaf Y, Buskens E. Is centralization of ovarian cancer care warranted? A cost-effectiveness analysis. Gynecol Oncol. 2009;113(1):68–74.View Article
  40. Bristow RE, Santillan A, Diaz-Montes TP, Gardner GJ, Giuntoli RL 2nd, Meisner BC, et al. Centralization of care for patients with advanced-stage ovarian cancer: a cost-effectiveness analysis. Cancer. 2007;109(8):1513–22.View Article
  41. Nelson G, Altman AD, Nick A, Meyer LA, Ramirez PT, Achtari C, et al. Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: enhanced recovery after surgery (ERAS(R)) society recommendations—Part I. Gynecol Oncol. 2016;140(2):313–22.View Article
  42. Nelson G, Altman AD, Nick A, Meyer LA, Ramirez PT, Achtari C, et al. Guidelines for postoperative care in gynecologic/oncology surgery: enhanced recovery after surgery (ERAS(R)) society recommendations–Part II. Gynecol Oncol. 2016;140(2):323–32.View Article
  43. Socias MC, Perez-Benavente MA, Sanchez-Iglesias JL, Manrique-Munoz S, Burgos-Pelaez R, Pamies-Serrano M, et al. PROFAST: eRAS in advanced ovarian cancer, a randomised trial. Clin Nutr ESPEN. 2016;12:e48–9.View Article
  44. Lakhman Y, Akin O, Sohn MJ, Zheng J, Moskowitz CS, Iyer RB, et al. Early postoperative CT as a prognostic biomarker in patients with advanced ovarian, tubal, and primary peritoneal cancer deemed optimally debulked at primary cytoreductive surgery. AJR Am J Roentgenol. 2012;198(6):1453–9.View Article
  45. Lorusso D, Sarno I, Di Donato V, Palazzo A, Torrisi E, Pala L, et al. Is postoperative computed tomography evaluation a prognostic indicator in patients with optimally debulked advanced ovarian cancer? Oncology. 2014;87(5):293–9.View Article
  46. Burger IA, Goldman DA, Vargas HA, Kattan MW, Yu C, Kou L, et al. Incorporation of postoperative CT data into clinical models to predict 5-year overall and recurrence free survival after primary cytoreductive surgery for advanced ovarian cancer. Gynecol Oncol. 2015;138(3):554–9.View Article
  47. Chi DS, Ramirez PT, Teitcher JB, Mironov S, Sarasohn DM, Iyer RB, et al. Prospective study of the correlation between postoperative computed tomography scan and primary surgeon assessment in patients with advanced ovarian, tubal, and peritoneal carcinoma reported to have undergone primary surgical cytoreduction to residual disease 1 cm or less. J Clin Oncol. 2007;25(31):4946–51.View Article
  48. Heitz F, Harter P, Avall-Lundqvist E, Reuss A, Pautier P, Cormio G, et al. The prognostic value of tumor residuals indicated by surgeon, by radiology or an integrated approach by surgeons’ assessment and pre-chemotherapy CT-scan in patients with advanced ovarian cancer: An exploratory analysis of the AGO Study led Intergroup trial AGO-OVAR 12. J Clin Oncol. 2017;35(15_suppl):5521.
Metadata
Title
Optimization of surgical treatment of advanced ovarian cancer: a Spanish expert perspective
Authors
L. Minig
J. de Santiago
S. Domingo
A. Gil-Moreno
S. Martínez
A. Rodríguez-Garzotto
L. Chiva
Publication date
01-05-2019
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 5/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-018-1967-4

Other articles of this Issue 5/2019

Clinical and Translational Oncology 5/2019 Go to the issue

Review Article

HER2 in stemness and epithelial–mesenchymal plasticity of breast cancer

Research Article

The clinicopathological and prognostic value of programmed death-ligand 1 in colorectal cancer: a meta-analysis

Research Article

Antigen-loaded dendritic cells triggers a specific cytotoxic T lymphocytes immune response against hepatocellular carcinoma: in vitro study

Research Article

Status of hydration assessed by bioelectrical impedance analysis: a valuable predictive factor for radiation-induced oral mucositis in head and neck cancer patients

Correction

Correction to: SEOM clinical guideline for treatment of kidney cancer (2017)

Research Article

Re-irradiation of recurrent glioblastoma as part of a sequential multimodality treatment concept
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits