Luis Chiva1, Fernando Lapuente2, Teresa Castellanos2, Sonsoles Alonso2, Antonio Gonzalez-Martin3. 1. Department of Gyecologic Oncology, MD Anderson Cancer Center, Madrid, Spain. lchiva@mdanderson.es. 2. Department of Gyecologic Oncology, MD Anderson Cancer Center, Madrid, Spain. 3. Department of Oncology, MD Anderson Cancer Center, Madrid, Spain.
Abstract
PURPOSE: To compare the impact, in terms of survival, of complete cytoreduction after primary debulking surgery (PDS) and interval debulking surgery (IDS) in patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stages III-IV) by reviewing the recent literature. METHODS: A search of the PubMed database during the last 7 years (2008-2014) was carried out looking for studies specifically showing data on median survival or disease-free survival after complete cytoreduction after either PDS or IDS. RESULTS: We found 24 publications including 14,182 patients with stages III to IV ovarian cancer. A total of 11871 patients (83.7 %) underwent PDS and 2311 (16.3 %) underwent interval debulking after neoadjuvant chemotherapy. A total of 4684 patients (33 %) were considered completely resected with microscopic residual disease. After PDS, the weighted average of median overall and progression-free survival was 43 and 17 months, respectively, for the whole group. After IDS, median and progression-free survival were 33 and 14 months. The rate of complete cytoreduction after PDS was inferior to the obtained in patients with IDS (27 vs. 59 %). However, the median survival in patients with complete cytoreduction with primary cytoreduction was 23 months longer than in the group with interval debulking (69 vs. 45 months). CONCLUSIONS: Complete cytoreduction after IDS yields a inferior outcome in terms of median survival than PDS of almost 2 years. Despite the higher rate of complete resection, IDS apparently fails to improve the results obtained by primary debulking.
PURPOSE: To compare the impact, in terms of survival, of complete cytoreduction after primary debulking surgery (PDS) and interval debulking surgery (IDS) in patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics stages III-IV) by reviewing the recent literature. METHODS: A search of the PubMed database during the last 7 years (2008-2014) was carried out looking for studies specifically showing data on median survival or disease-free survival after complete cytoreduction after either PDS or IDS. RESULTS: We found 24 publications including 14,182 patients with stages III to IV ovarian cancer. A total of 11871 patients (83.7 %) underwent PDS and 2311 (16.3 %) underwent interval debulking after neoadjuvant chemotherapy. A total of 4684 patients (33 %) were considered completely resected with microscopic residual disease. After PDS, the weighted average of median overall and progression-free survival was 43 and 17 months, respectively, for the whole group. After IDS, median and progression-free survival were 33 and 14 months. The rate of complete cytoreduction after PDS was inferior to the obtained in patients with IDS (27 vs. 59 %). However, the median survival in patients with complete cytoreduction with primary cytoreduction was 23 months longer than in the group with interval debulking (69 vs. 45 months). CONCLUSIONS: Complete cytoreduction after IDS yields a inferior outcome in terms of median survival than PDS of almost 2 years. Despite the higher rate of complete resection, IDS apparently fails to improve the results obtained by primary debulking.
Authors: Alfredo Perales-Puchalt; Krzysztof Wojtak; Elizabeth K Duperret; Xue Yang; Anna M Slager; Jian Yan; Kar Muthumani; Luis J Montaner; David B Weiner Journal: Mol Ther Date: 2018-12-13 Impact factor: 11.454
Authors: Vasileios D Sioulas; Maria B Schiavone; David Kadouri; Oliver Zivanovic; Kara Long Roche; Roisin O'Cearbhaill; Nadeem R Abu-Rustum; Douglas A Levine; Yukio Sonoda; Ginger J Gardner; Mario M Leitao; Dennis S Chi Journal: Gynecol Oncol Date: 2017-02-21 Impact factor: 5.482
Authors: Angelo Di Giorgio; Pierandrea De Iaco; Michele De Simone; Alfredo Garofalo; Giovanni Scambia; Antonio Daniele Pinna; Giorgio Maria Verdecchia; Luca Ansaloni; Antonio Macrì; Paolo Cappellini; Valerio Ceriani; Giorgio Giorda; Daniele Biacchi; Marco Vaira; Mario Valle; Paolo Sammartino Journal: Ann Surg Oncol Date: 2016-11-28 Impact factor: 5.344