Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer

Coleridge, Sarah; Bryant, Andrew; Lyons, Thomas J; Goodall, Richard; Kehoe, Sean; Morrison, Jo

doi:10.1002/14651858.cd005343.pub4

Cited by 46 publications

(42 citation statements)

References 145 publications

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“…Although some of them have been already recommended by updated NCCN guidelines for ETOC and PPSC treatment [4,26], they are not widely used in the routine clinical practice [60]. Among these, induction chemotherapy (neoadjuvant chemotherapy-NACT) using either standard form of paclitaxel and carboplatin or its modification form, including dose-dense or high-dose chemotherapy, and in additional adding bevacizumab, has become more and more popular, especially for those patients who are not candidates for immediate PCS [61][62][63][64][65][66][67][68][69].…”

Section: Current Standard Of Treatmentmentioning

confidence: 99%

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

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The use of weekly chemotherapy for the treatment of patients with advanced-stage serous-type epithelial Tubo-ovarian cancer (ETOC), and primary peritoneal serous carcinoma (PPSC) is acceptable as the front-line postoperative chemotherapy after primary cytoreductive surgery (PCS). The main component of dose-dense chemotherapy is weekly paclitaxel (80 mg/m2), but it would be interesting to know what is the difference between combination of triweekly cisplatin (20 mg/m2) or triweekly carboplatin (carboplatin area under the curve 5-7 mg/mL per min [AUC 5-7]) in the dose-dense paclitaxel regimen. Therefore, we compared the outcomes of women with Gynecology and Obstetrics (FIGO) stage IIIC ETOC and PPSC treated with PCS and a subsequent combination of dose-dense weekly paclitaxel and triweekly cisplatin (paclitaxel–cisplatin) or triweekly carboplatin using AUC 5 (paclitaxel–carboplatin). Between January 2010 and December 2016, 40 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC EOC, FTC, or PPSC were enrolled, including 18 treated with paclitaxel–cisplatin and the remaining 22 treated with paclitaxel–carboplatin. There were no statistically significant differences in disease characteristics of patients between two groups. Outcomes in paclitaxel–cisplatin group seemed to be little better than those in paclitaxel–carboplatin (median progression-free survival [PFS] 30 versus 25 months as well as median overall survival [OS] 58.5 versus 55.0 months); however, neither reached a statistically significant difference. In terms of adverse events (AEs), patients in paclitaxel–carboplatin group had more AEs, with a higher risk of neutropenia and grade 3/4 neutropenia, and the need for a longer period to complete the front-line chemotherapy, and the latter was associated with worse outcome for patients. We found that a period between the first-time chemotherapy to the last dose (6 cycles) of chemotherapy >21 weeks was associated with a worse prognosis in patients compared to that ≤21 weeks, with hazard ratio (HR) of 81.24 for PFS and 9.57 for OS. As predicted, suboptimal debulking surgery (>1 cm) also contributed to a worse outcome than optimal debulking surgery (≤1 cm) with HR of 14.38 for PFS and 11.83 for OS. Based on the aforementioned findings, both regimens were feasible and effective, but maximal efforts should be made to achieve optimal debulking surgery and following the on-schedule administration of dose-dense weekly paclitaxel plus triweekly platinum compounds. Randomized trials validating the findings are warranted.

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Section: Current Standard Of Treatmentmentioning

confidence: 99%

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Huang

Chen

Lee

et al. 2020

IJERPH

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“…Most of these comprise of advanced ovarian cancers and neoadjuvant treatment is non inferior to extensive cytoreductive surgery. [27] There is a clause on performing extensive cytoreductive surgery (CRS) during the pandemic as intensive care beds need to be reserved preferably for COVID patients. Reduced blood donation camps leading to shortage of blood products also is a limiting factor for performing CRS with or without HIPEC.…”

Section: Resultsmentioning

confidence: 99%

Impact of COVID-19 pandemic on gynecological oncology care: Glimpse into Association of Gynecological Oncologists of India (AGOI) perspective

Bhandoria

Shylasree

Bhandarkar

et al. 2020

Preprint

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Purpose: The notorious COVID 19 pandemic has caused rapid and drastic changes in cancer care all over the world in 2020. This online survey aims to assess the extent to which the pandemic has affected cancer care in gynecological oncology amongst members of Association of Gynecological Oncologists of India (AGOI), a registered professional society, founded in 1991. Methods: We developed and administered a cross-sectional, flash survey to members of The Association of Gynecological Oncologists of India (AGOI) in the first week of April 2020. Data were analyzed using Microsoft Office Excel 2016. Results were expressed as percentages of total responses excluding blank or unattended response. Overall theme-specific responses were expressed as a spectrum of finding and related inferences were drawn.Results: Among approached practitioners, 90 responded to the survey, more than 80 % were practicing consultants and more than 50 % from academic institutions. Results of the survey showed that the ongoing pandemic had severely affected gynecological oncology practice and care amongst all responders. There were modifications in diagnostic pathways, interventions and follow ups across all organ sites. There was near unanimous opinion on use of general safety measures to combat the virus and to use complete PPEs in high risk situation. There was mixed responses to alternative educational activities especially using electronic technology and distant learning methods. There was an optimism among responders with regards to the current situation normalizing in 3 to 6 months. Conclusion: This study documents the pandemic affected scenario of gynecological cancer care and perceptions of Gynecological Oncologists in India. Significant effect on all aspects of cancer care were observed. Technological learning methods both for patient care and educational activities were being adopted by many responders. Keywords: COVID-19, pandemic, gynecological oncology care, survey, AGOI

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“…In this study, primary debulking surgery (PDS) was better in OS and DFS than interval debulking surgery (IDS) for FIGO stage III epithelial ovarian carcinoma. In most of the previous studies, there is no consensus regarding this point which may be due to combining both FIGO stage III and IV as advanced ovarian cancer as well as the differences in the design of the studies [13]- [18]. Therefore, in our study, we evaluated FIGO stage III epithelial ovarian carcinoma separately that may explain more details about the outcome of this category of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, Bristow and Chi published a meta-analysis that involved more than 800 patients, showed that NACT compared with PDS was associated with a worse OS, and they suggested that the definitive operative intervention should be performed as early in the treatment program as possible [12]. However, a more recent meta-analysis of multiple central randomized trials concluded that survival was similar in patients treated with NACT followed by interval debulking surgery compared to primary debulking followed by chemotherapy, and they even criticized Bristow and Chi meta-analysis [13] [14]. Therefore, the aim of this retrospective study is to evaluate the outcome of IDS after primary NACT compared to PDS followed by adjuvant chemotherapy for FIGO stage III epithelial ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%

Primary Debulking Surgery for Stage III Epithelial Ovarian Cancer Has a Better Outcome Than Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery

Amin¹,

Ahmed²,

Refaat³

et al. 2020

JCT

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Background: Ovarian cancer (OC) is the most lethal gynecologic malignancy. About 70% of ovarian cancer patients have advanced disease and often not totally resectable. Previous studies of neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) versus primary debulking surgery (PDS) give inconsistent results. The aim of this retrospective study is to evaluate the outcome of the neoadjuvant chemotherapy followed by IDS versus PDS followed by adjuvant chemotherapy for the International Federation of Gynecology and Obstetrics (FIGO) stage III epithelial ovarian cancer. Methods: This study was performed on eligible patients with ovarian cancer admitted in Surgical Oncology and Medical Oncology departments at South Egypt Cancer Institute-Assiut University in the period from January 2010 to December 2015. Patients were divided into two groups, the first group included those who have NACT and underwent IDS plus adjuvant chemotherapy, and the second group included those who underwent PDS followed by adjuvant chemotherapy. Results: This study included 380 cases. One hundred and fifty-four patients (40.53%) had IDS. The remaining two hundred and twenty-six patients (59.47%) underwent PDS. In this study, treatment modality was significant for both disease-free survival (DFS) and overall survival (OS). DFS was significantly reduced after IDS when compared to PDS (median DFS: 33.00 months vs. 45.00 months, respectively; p < 0.001). Also, OS was significantly reduced after IDS when compared to PDS.

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Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer

Cited by 46 publications

References 145 publications

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Comparing Paclitaxel–Carboplatin with Paclitaxel–Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer

Impact of COVID-19 pandemic on gynecological oncology care: Glimpse into Association of Gynecological Oncologists of India (AGOI) perspective

Primary Debulking Surgery for Stage III Epithelial Ovarian Cancer Has a Better Outcome Than Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery

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