Improved Survival from Ovarian Cancer in Patients Treated in Phase III Trial Active Cancer Centres in the UK

Khoja, Leila; Nolan, Kathleen F.; Mekki, R; Milani, Andrea; Mescallado, Nerissa; Ashcroft, Linda; Hasan, Jurjees; Edmondson, Richard J.; Winter-Roach, Brett; Kitchener, Henry C; Mould, Tim; Hutson, Richard; Hall, Geoff; Perren, Timothy J.; Ledermann, Jonathan A.; Jayson, Gordon C

doi:10.1016/j.clon.2016.06.011

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…These data compare favourably with two large, randomizedcontrolled trials in women with advanced EOC where resection rates varied significantly between centres [3, 13] yet remain lower than those reported by other centres both nationally and internationally [10,11,14]. The median PFS of 14.3 months is similar to those reported in other UK populations and several international trials [10,15]. Despite a significant increase in the number of bowel resections (20.5% in group 1 vs. 42.7% in group 2) and an associated reduction in pelvic residual disease, a more aggressive surgical approach did not significantly improve rates of complete or optimal cytoreduction and no significant improvement in progression free survival was seen between the two groups.…”

Section: Resultssupporting

confidence: 77%

Improving surgical outcomes in advanced ovarian cancer: a UK centre quality improvement strategy

May

Congiu

Fegan

et al. 2019

Preprint

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Purpose National outcomes for epithelial ovarian cancer in the UK are inferior to those in other European countries. This study aimed to assess the impact of a multidisciplinary approach to cytoreductive surgery on residual disease status and progression free survival in a single UK region. Methods Consecutive patients undergoing surgery for stage III/IV epithelial ovarian cancer between November 2011 and November 2015 in South East Scotland were analysed. Regular multidisciplinary surgery was established on 1st November 2013. Outcomes for patients diagnosed in the two years prior to (group 1) and following this change (group 2) in practice were examined. Results 224 consecutive patients underwent surgery. There was no difference between groups in terms of age, FIGO stage or histological subtype. Patients in group 2 were more likely to undergo primary surgery (p=0.01) and bowel resection (p=0.002). Rates of optimal cytoreduction were not significantly different between group 1(69.6%) and group 2 (66.1%) (p=0.67). The upper abdomen was the most common site of residual disease. No difference in PFS (median PFS; 15.5 vs. 14.0 months, p=0.13), morbidity (p=0.82) or mortality (p=1.00) was identified. PFS was improved in those patients undergoing primary surgery compared to neoadjuvant chemotherapy (p=0.04). Conclusion Robust quality improvement strategies are required to overcome historic barriers to cytoreductive surgery in the UK. Comprehensive attempts at debulking in the upper abdomen are required if rates of complete cytoreduction are to be improved. We have extended the multidisciplinary model in our institution to include upper abdominal surgery and anticipate an improvement in cytoreduction.

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Section: Resultssupporting

confidence: 77%

Improving surgical outcomes in advanced ovarian cancer: a UK centre quality improvement strategy

May

Congiu

Fegan

et al. 2019

Preprint

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“…Ovarian cancer is one of the most common types of tumor in women worldwide, and exhibits increasing morbidity and mortality rates (1,2). Despite medical advances in surgical techniques, radiation, chemotherapy and gene target therapy, the five-year survival rate of patients with ovarian cancer remains poor (3,4). Resistance to anti-ovarian cancer therapies is a major issue in patients with recurrent ovarian cancer (5,6).…”

Section: Introductionmentioning

confidence: 99%

Tanshinone IIA induces apoptosis of ovarian cancer cells in�vitro and in�vivo through attenuation of PI3K/AKT/JNK signaling pathways

Zhang

Zhou

2018

Oncol Lett

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Ovarian cancer is one of the most common gynecological tumors and is the second most common cause of gynecological cancer-associated mortality worldwide. Tanshinone IIA (Tan-IIA) possesses anticancer activities through inducing the apoptosis of tumor cells. The purpose of the present study was to analyze the ability of Tan-IIA to induce apoptosis of human ovarian cancer cells in vitro and in vivo, and to examine the potential mechanism underlying its activity. Western blot analysis, immunohistochemistry and flow cytometry were used to analyze the therapeutic effects of Tan-IIA on ovarian cancer. It was demonstrated that Tan-IIA significantly inhibited the growth and aggressiveness of human ovarian cancer cells. Tan-IIA significantly increased the apoptosis of human ovarian cancer cells through cleavage activation of caspases-3, caspase-8 and caspases-9. In addition, Tan-IIA treatment decreased the expression of mitochondrial-protective B-cell lymphoma 2-like protein 2 (Bcl-w) and myeloid cell leukemia-1 long (Mcl-1L) in ovarian cancer cells. Tan-IIA also reduced the expression of phosphoinositide 3-kinase (PI3K), AKT and c-Jun N-terminal kinase (JNK) in human ovarian cancer cells. A specific PI3K inhibitor (LY294002) enhanced the Tan-IIA-inhibited expression of AKT and JNK. The overexpression of PI3K negated the Tan-IIA-inhibited expression of AKT and JNK, and eliminated the Tan-IIA-induced apoptosis of human ovarian cancer cells. Additionally, the in vivo assay showed that Tan-IIA treatment inhibited the growth of ovarian cancer through increasing the apoptosis of tumor cells. In conclusion, these findings suggested that the induction of apoptosis by Tan-IIA involves the PI3K/AKT/JNK signaling pathways in ovarian cancer.

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“…Work within NCRAS is underway to identify patients in whom tumour BRCA testing was performed. Evidence strongly suggests that patients want to participate in research trials, those who do have better outcomes, and centres with greater research recruitment deliver better outcomes for patients [9]. Data on research participation are collected routinely through the collaborative research networks and can be assessed and reported.…”

Section: Best Practice Solutionsmentioning

confidence: 99%

“…Particular concerns are around those patients with widespread advanced, or relapsed, disease who require specialised abdominal surgery. Limited infrastructure resources, including operating theatre time, intensive care capacity, gaps in surgical skills training, workforce pressures, and diagnostic delays, are key contributors to suboptimal care despite the implementation of a centralised model [6][7][8][9][10]. The effect of the limitations are reflected in ovarian cancer survival statistics, with the UK lagging behind comparable countries [11].…”

Section: Introductionmentioning

confidence: 99%

British Gynaecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer

Sundar

Nordin

Morrison

et al. 2023

Cancers

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Ovarian cancer survival in the UK lags behind comparable countries. Results from the ongoing National Ovarian Cancer Audit feasibility pilot (OCAFP) show that approximately 1 in 4 women with advanced ovarian cancer (Stage 2, 3, 4 and unstaged cancer) do not receive any anticancer treatment and only 51% in England receive international standard of care treatment, i.e., the combination of surgery and chemotherapy. The audit has also demonstrated wide variation in the percentage of women receiving anticancer treatment for advanced ovarian cancer, be it surgery or chemotherapy across the 19 geographical regions for organisation of cancer delivery (Cancer Alliances). Receipt of treatment also correlates with survival: 5 year Cancer survival varies from 28.6% to 49.6% across England. Here, we take a systems wide approach encompassing both diagnostic pathways and cancer treatment, derived from the whole cohort of women with ovarian cancer to set out recommendations and quality performance indicators (QPI). A multidisciplinary panel established by the British Gynaecological Cancer Society carefully identified QPI against criteria: metrics selected were those easily evaluable nationally using routinely available data and where there was a clear evidence base to support interventions. These QPI will be valuable to other taxpayer funded systems with national data collection mechanisms and are to our knowledge the only population level data derived standards in ovarian cancer. We also identify interventions for Best practice and Research recommendations.

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Improved Survival from Ovarian Cancer in Patients Treated in Phase III Trial Active Cancer Centres in the UK

Abstract: The data suggest that international survival statistics are achieved in UK regional cancer centres.

Cited by 8 publications

References 17 publications

Improving surgical outcomes in advanced ovarian cancer: a UK centre quality improvement strategy

Improving surgical outcomes in advanced ovarian cancer: a UK centre quality improvement strategy

Tanshinone IIA induces apoptosis of ovarian cancer cells in�vitro and in�vivo through attenuation of PI3K/AKT/JNK signaling pathways

British Gynaecological Cancer Society Recommendations for Evidence Based, Population Data Derived Quality Performance Indicators for Ovarian Cancer

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