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
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2007

01-03-2007 | Gynecology

Secondary Cytoreductive Surgery in Patients with Platinum-Sensitive Recurrent Ovarian Cancer

Authors: Pierluigi Benedetti Panici, MD, Antonio De Vivo, MD, Filippo Bellati, MD, Natalina Manci, MD, Giorgia Perniola, MD, Stefano Basile, MD, Ludovico Muzii, MD, Roberto Angioli, MD

Published in: Annals of Surgical Oncology | Issue 3/2007

Login to get access

ABSTRACT

Background

Secondary surgical cytoreduction (SCR) represents a promising therapeutic strategy for patients affected by ovarian cancer disease recurrence. The aim of this prospective observational trial was to analyze the role of SCR in patients with platinum-sensitive ovarian cancer.

Methods

Patients with platinum-sensitive ovarian cancer underwent SCR by a single surgical team. Clinical and oncologic data were prospectively recorded. A total of 47 patients underwent SCR from 1999 to 2003.

Results

The mean operating time was 210 minutes, and mean blood loss was 500 mL. The most frequent surgical procedures carried out were splenectomy, lymphadenectomy, bowel resection, and extensive peritonectomy. Optimal cytoreduction was achieved in 41 patients. Thirty-seven patients had no visible tumor at the end of SCR. Overall median survival was 49 months. Patients who achieved optimal residual disease had a median survival of 61 months, whereas patients who had residual disease >1 cm had a median survival of 19 months.

Conclusions

Positive CA-125 (cancer antigen 125) was identified as a negative prognostic factor at multivariate analysis. After careful selection, optimal cytoreduction can be achieved in most patients who are subjected to SCR with acceptable morbidity. Residual tumor and CA-125 represent the most important prognostic factors.
Literature
1.
Jemal A, Tiwari RC, Murray T, et al. American Cancer Society Cancer statistics, 2004. CA Cancer J Clin 2004; 54:8–29PubMed
2.
Young JA, Garretson F, Westlake DL, Illig WP, Vogl SE. Intraperitoneal cisplatin with intravenous cyclophosphamide and doxorubicin for previously untreated stage III and IV ovarian carcinoma. Cancer Invest 1989; 7:565–70PubMed
3.
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin 2003; 53:5–26PubMedCrossRef
4.
Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20:1248–59PubMedCrossRef
5.
Griffiths CT. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr 1975; 42:101–4PubMed
6.
7.
Hacker NF, Berek JS, Lagasse LD, Nieberg RK, Elashoff RM. Primary cytoreductive surgery for epithelial ovarian cancer. Obstet Gynecol 1983; 61:413–20PubMed
8.
McGuire WP. High-dose chemotherapy and autologous bone marrow or stem cell reconstitution for solid tumors. Curr Probl Cancer 1998; 22:135–77PubMedCrossRef
9.
Berek JS, Hacker NF, Lagasse LD, Poth T, Resnick B, Nieberg RK. Second-look laparotomy in stage III epithelial ovarian cancer: clinical variables associated with disease status. Obstet Gynecol 1984; 64:207–12PubMed
10.
Rubin SC, Randall TC, Armstrong KA, Chi DS, Hoskins WJ. Ten-year follow-up of ovarian cancer patients after second-look laparotomy with negative findings. Obstet Gynecol 1999; 93:21–4PubMedCrossRef
11.
Berek JS, Bertelsen K, du Bois A, et al. Advanced epithelial ovarian cancer: 1998 consensus statements. Ann Oncol 1999; 10:87–92PubMedCrossRef
12.
Eisenkop SM, Friedman RL, Spirtos NM. The role of secondary cytoreductive surgery in the treatment of patients with recurrent epithelial ovarian carcinoma. Cancer 2000; 88:144–53PubMedCrossRef
13.
Zang RY, Li ZT, Tang J, et al. Secondary cytoreductive surgery for patients with relapsed epithelial ovarian carcinoma: who benefits? Cancer 2004; 100:1152–61PubMedCrossRef
14.
Petterson F. International Federation of Gynecology and Obstetrics Report. Stockholm: International Federation of Gynecology and Obstetrics, 1988; 110–51
15.
Berek JS, Hacker NF, Lagasse LD, Nieberg RK, Elashoff RM. Survival of patients following secondary cytoreductive surgery in ovarian cancer. Obstet Gynecol 1983; 61:189–93PubMed
16.
Morris M, Gershenson DM, Wharton JT, Copeland LJ, Edwards CL, Stringer CA. Secondary cytoreductive surgery for recurrent epithelial ovarian cancer. Gynecol Oncol 1989; 34:334–8PubMedCrossRef
17.
Janicke F, Holscher M, Kuhn W, et al. Radical surgical procedure improves survival time in patients with recurrent ovarian cancer. Cancer 1992; 70:2129–36PubMedCrossRef
18.
Segna RA, Dottino PR, Mandeli JP, Konsker K, Cohen CJ. Secondary cytoreduction for ovarian cancer following cisplatin therapy. Clin Oncol 1993; 11:434–9
19.
Vaccarello L, Rubin SC, Vlamis V, et al. Cytoreductive surgery in ovarian carcinoma patients with a documented previously complete surgical response. Gynecol Oncol 1995; 57:61–5PubMedCrossRef
20.
Gadducci A, Iacconi P, Cosio S, Fanucchi A, Cristofani R, Riccardo Genazzani A. Complete salvage surgical cytoreduction improves further survival of patients with late recurrent ovarian cancer. Gynecol Oncol 2000; 79:344–9PubMedCrossRef
21.
Munkarah A, Levenback C, Wolf JK, et al. Secondary cytoreductive surgery for localized intra-abdominal recurrences in epithelial ovarian cancer. Gynecol Oncol 2001; 81:237–41PubMedCrossRef
22.
Scarabelli C, Gallo A, Carbone A. Secondary cytoreductive surgery for patients with recurrent epithelial ovarian carcinoma. Gynecol Oncol 2001; 83:504–12PubMedCrossRef
23.
Tay EH, Grant PT, Gebski V, Hacker NF. Secondary cytoreductive surgery for recurrent epithelial ovarian cancer. Obstet Gynecol. 2002; 99:1008–13PubMedCrossRef
24.
Pfisterer J, Harter P, Canzler U, et al. The role of surgery in recurrent ovarian cancer.Int J Gyn Cancer 2005; 15:195–198CrossRef
25.
Ayhan A, Gultekin M, Taskiran C, et al. The role of secondary cytoreduction in the treatment of ovarian cancer: Hacettepe University experience. Am J Ostet Gynecol 2006; 194:49–56CrossRef
26.
Chi DS, McCaughty K, Diaz JP, et al. Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma. Cancer 2006; 106:1933–9PubMedCrossRef
27.
Kehoe S, Powell J, Wilson S, Woodman C. The influence of the operating surgeon’s specialisation on patient survival in ovarian carcinoma. Br J Cancer 1994; 70:1014–7PubMed
28.
Junor EJ, Hole DJ, McNulty L, Mason M, Young J. Specialist gynaecologists and survival outcome in ovarian cancer: a Scottish national study of 1866 patients. Br J Obstet Gynaecol 1999; 106:1130–6PubMed
Metadata
Title
Secondary Cytoreductive Surgery in Patients with Platinum-Sensitive Recurrent Ovarian Cancer
Authors
Pierluigi Benedetti Panici, MD
Antonio De Vivo, MD
Filippo Bellati, MD
Natalina Manci, MD
Giorgia Perniola, MD
Stefano Basile, MD
Ludovico Muzii, MD
Roberto Angioli, MD
Publication date
01-03-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 3/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9273-8

Other articles of this Issue 3/2007

Annals of Surgical Oncology 3/2007 Go to the issue

OriginalPaper

Comparison Between Local Ablative Therapy and Chemotherapy for Non-Resectable Colorectal Liver Metastases: A Prospective Study

OriginalPaper

Role of the BRAF Mutations in the Microsatellite Instability Genetic Pathway in Sporadic Colorectal Cancer

Editorial

Con: Sentinel Lymph Node Biopsy for DCIS. The Breast Surgeon is not a Barber

OriginalPaper

Gene Expression Profile of Primary Gastric Cancer: Towards the Prediction of Lymph Node Status

OriginalPaper

Expression of Tumor Antigens and Heat-Shock Protein 70 in Breast Cancer Cells After High-Intensity Focused Ultrasound Ablation

OriginalPaper

Resection of Isolated Pelvic Recurrences After Colorectal Surgery: Long-Term Results and Predictors of Improved Clinical Outcome