A risk model for secondary cytoreductive surgery in recurrent ovarian cancer: An evidence-based proposal for patient selection.

Tian, Wei; Chi, Dongmei; Sehouli, Jalid; Tropé, C.; Jiang, Rong; Ayhan, Ali; Cormio, Gennaro; Xing, Yang; Breitbach, G. P.; Braicu, EI; Rabbitt, Catherine; Oksefjell, H.; Fotopoulou, C; Meerpohl, H. G.; Bois, Andreas du; Berek, Jonathan S.; Zang, Rong Yu; Harter, P

doi:10.1200/jco.2011.29.15_suppl.5053

Cited by 15 publications

(24 citation statements)

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“…The preoperative ECOG performance status was also included in the model but only scarce literature is available on the role of ECOG performance status and its impact on the risk of surgical adverse events in endometrial cancer. However, performance status has been shown to be related to clinical outcomes including survival in other cancers (18)(19)(20)(21)(22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Kondalsamy‐Chennakesavan

Janda

Gebski

et al. 2012

European Journal of Cancer

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Aims: To identify risk factors for major Adverse Events (AEs) and to develop a nomogram to predict the probability of such AEs in individual patients who have surgery for apparent early stage endometrial cancer. Methods:We used data from 753 patients who were randomized to either total laparoscopic hysterectomy or total abdominal hysterectomy in the LACE trial. Serious adverse events that prolonged hospital stay or postoperative adverse events (using common terminology criteria 3+, CTCAE V3) were considered major AEs. We analyzed pre-surgical characteristics that were associated with the risk of developing major AEs by multivariate logistic regression.We identified a parsimonious model by backward stepwise logistic regression. The six most significant or clinically important variables were included in the nomogram to predict the risk of major AEs within 6 weeks of surgery and the nomogram was internally validated.Results: Overall, 132 (17.5%) patients had at least one major AE. An open surgical approach (laparotomy), higher Charlson's medical co-morbidities score, moderately differentiated tumours on curettings, higher baseline ECOG score, higher body mass index and low haemoglobin levels were associated with AE and were used in the nomogram. The bootstrap corrected concordance index of the nomogram was 0.63 and it showed good calibration. Conclusions:Six pre-surgical factors independently predicted the risk of major AEs. This research might form the basis to develop risk reduction strategies to minimize the risk of AEs among patients undergoing surgery for apparent early stage endometrial cancer. Clinical Trial Registration: NCT00096408

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Section: Discussionmentioning

confidence: 99%

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Kondalsamy‐Chennakesavan

Janda

Gebski

et al. 2012

European Journal of Cancer

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“…The smaller the tumor burden, the greater the number of potential candidates for resection [ 46 ]. Several retrospective studies have tried to identify the best candidates for secondary cytoreduction.…”

Section: Does Secondary Cytoreductive Surgery Benefi T a Subset Of Pamentioning

confidence: 99%

“…Waiting for symptomatic recurrence will limit the number of agents that can be given and the chance for longer survival. In relapsed ovarian cancer, improved performance status is regarded as a prognostic factor of response to chemotherapy [ 25 ] and to surgery [ 46 ]. If only symptomatic patients were treated, outcomes with optimal conventional chemotherapy are likely to be compromised.…”

Section: Nomentioning

confidence: 99%

Recurrent Ovarian Cancer: When to Treat and How to Assess

Roux

Romero

Zweifel

et al. 2013

Controversies in the Management of Gynecological Cancers

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“…Recently, selection criteria for operable patients with recurrent ovarian cancer were suggested by the DESKTOP trial: i) Good PS, ii) no or small volume of ascites at recurrence, and iii) no gross residual disease after primary surgery (14). Another study suggested that the predictive factors for complete resection at SDS included FIGO stage, complete primary surgery, PFI, PS, CA125 value at recurrence and ascites at recurrence (15). In the present study, none of the patients who underwent SDS had ascites, but some patients who had not met these criteria still achieved long-term survival.…”

Section: Long-term Short-term Survivors N (%) Survivors N (%) -----mentioning

confidence: 99%

Factors favouring long-term survival following recurrence in ovarian cancer

Soyama

Takano

Miyamoto

et al. 2017

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to identify clinicopathological factors in long-term survivors following ovarian cancer recurrence. The patients who achieved longer survival after recurrence (n=18) and those who succumbed to the disease earlier (n=47) were identified and analyzed. There were no significant differences in age, performance status, stage distribution or histology between the two groups. Additionally, no significant difference was observed in progression-free survival after primary therapy. Multivariate analyses revealed that the predictive factors for long-term survival were i) secondary debulking surgery (OR=13.3; 95% CI: 1.39-226.7), ii) favourable response rate of second-line chemotherapy (OR=46.5; 95% CI: 1.84-313-4), and iii) ≥3 regimens after first recurrence (OR=9.01; 95% CI: 1.28-117.7). This study revealed that prolonged post-progression survival was associated with post-recurrence treatment. Therefore, appropriate selection of secondary debulking surgery and better chemotherapeutic response may lead to prolonged post-progression survival in recurrent ovarian cancer patients.

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A risk model for secondary cytoreductive surgery in recurrent ovarian cancer: An evidence-based proposal for patient selection.

Cited by 15 publications

References 0 publications

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Risk factors to predict the incidence of surgical adverse events following open or laparoscopic surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Recurrent Ovarian Cancer: When to Treat and How to Assess

Factors favouring long-term survival following recurrence in ovarian cancer

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