Recurrent ovarian carcinoma: Salvage treatment with platinum in patients responding to first-line platinum-based regimens

Chiara, S.; Campora, E; Merlini, Laura; Simoni, C.; Rosso, Riccardo; Iskra, L; Odicino, Franco; Ragni, Nicola; Conte, Pierfranco

doi:10.1016/s0959-8049(05)80192-3

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Chiara et al [ 52 ] treated 9 chemotherapy-naive women with recurrent (2 patients) or high risk factors aGCT with cisplatin, cyclophosphamide with or without doxorubicin or cisplatin, etoposide, and bleamycin (PVP-16B), clinical CR was achieved in the 2 patients with recurrent disease. Five patients underwent second look surgery which documented: CR in 3 patients, PR in 1 patient, and progressive disease in 1 case.…”

Section: Discussionmentioning

confidence: 99%

Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?

et al. 2022

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Adult granulosa cell tumors (aGCTs) are rare ovarian neoplasms with a relatively favorable prognosis. They follow an indolent course, characterized by a prolonged natural history and a tendency to late recurrences, Around a quarter of patients develop recurrence and More than 70% of women with recurrence die from their disease, The percentage of patients received chemotherapy increases over time, whether adjuvant chemotherapy improve the prognosis of aGCTs is equivocal? The purpose of this review is to summarize the previously published evidence to evaluate whether adjuvant chemotherapy improve the prognosis of aGCTs to provide guidance for clinical practice. EMBASE, PubMed, Web of Science, WanFang Data and Chinese National Knowledge Infrastructure are searched up to December 2020, used the search strategy of ovar * and granulosa cell * and (tumor * or tumour * or malignan * or cancer * or carcinom * or neoplasm * ) and chemotherapy. The screening process was conducted strictly based on inclusion and exclusion criteria. Clinical studies based on human including randomized controlled trial, quasi-randomised controlled trials, nonrandomised trials cohort study and case control study were included without restriction of time. The percentage of patients received chemotherapy increases over time, but the benefit of adjuvant chemotherapy is lack of high-grade evidence of prospective study, based on the current retrospective studies, we still do not have the evidence to confirm the survival benefit of adjuvant chemotherapy in early stage, advanced stage or recurrent aGCT with no residual tumor, but for inoperable disseminated disease or disease with suboptimal cytoreduction, adjuvant chemotherapy maybe an Optable options. Multinational prospective randomised controlled trials are urgently needed to validate the role of adjuvant chemotherapy. Further research on molecular mechanisms and developing novel targeted medicines may improve the survival of aGCTs.Abbreviations: ACG = adjuvant chemotherapy group, aGCTs = adult granulosa cell tumors, BEP = bleomycin, etoposide, and cisplatin, CR = complete response, DFS = disease-free survival, FIGO = Federation International of Gynecology and Obstetrics, FOXL2 = fork head box protein L2, GCTs = granulosa cell tumors, GOG = Gynecologic Oncology Group, KMT2D = histone-lysine Nmethyltransferase 2D, HER = human epidermal growth factor receptors, NCCN = National Comprehensive Cancer Network, OS = overall survival, PFS = progression-free survival, PR = partial response, PVB = cisplatin, vinblastine, and bleomycin, RCTs = randomized controlled trials, TERT = telomerase reverse transcriptase, TP53 = tumor protein p53.

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Section: Discussionmentioning

confidence: 99%

Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?

et al. 2022

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“…Currently, NCCN (National Comprehensive Cancer Network) recommends either paclitaxel and carboplatin or bleomycin, etoposide, and cisplatin (malignant germ cell tumor) regimens for stage II to IV GCT. 15 There are multiple studies which show no clinical benefit from adjuvant chemotherapy, 7 11 16 17 18 19 20 while certain others have shown survival benefits. 6 8 9 10 21 22 23 24 25 26 Meisel et al 9 in turn reported a trend of earlier recurrence of patients who underwent adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Granulosa Cell Tumors: A Retrospective Study in a Tertiary Care Cancer Centre of Eastern India

Kulkarni

Nayak

Parija

et al. 2022

South Asian J Cancer

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Background and Aims The main objective of this study was to analyze the clinicopathological profile and prognostic factors of granulosa cell tumor (GCT). Method All the cases of ovarian cancer which were seen at our institute between January 2000 and December 2017 were reviewed. Data were analyzed with failure-free survival (FFS) as the primary end point. Results GCTs consisted of 2.66% of all ovarian cancers at our institute. The median age was 43 years. Majority of the patients (62.5%) were unstaged. Six patients (25%) had a fertility-preserving procedure. Forty two percent of the patients received adjuvant chemotherapy. Thirty eight percent of the patients developed recurrence. Considering tumor-related prognostic factors, there was a statistically significant decrease in FFS with the presence of hemorrhage (p = < 0.001), larger tumors (p = 0.042), and juvenile variant (p = 0.002). On the contrary, when treatment-related factors were considered, there was no statistically significant improvement in FFS with the performance of lymphadenectomy (p = 0.218), omentectomy (p = 0.453), fertility sparing surgery (p = 0.152), or administration of adjuvant chemotherapy (p = 0.45). Conclusion Inherent tumor-related biological factors tend to play a more important role compared with treatment-related factors in GCTs. Hence, the traditional practice of performance of extensive staging procedures and routine adjuvant chemotherapy should be reviewed. Fertility-preserving surgery appears safe to be offered in early stages when desired. Although it is common knowledge that GCTs tend to be hemorrhagic tumors, this factor has not been well recognized as a prognostic indicator till date. Our study sheds some light on this aspect. Since these tumors have a tendency toward late recurrences, a long follow-up is prudent.

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“…Introduction When comparing two treatments on the basis of an ordinal endpoint, the data can be summarized as a 2xJ contingency table. The objective tumor response data, e.g., from 35 ovarian cancer patients treated with cisplatin-based combination chemotherapy and salvage platinum-based therapy (Chiara et al, 1993) are (4,7,2,2) and (1,6,7,6) for patients with treatment-free intervals ≤ 12 months and > 12 months, respectively, with categories for 'progressive disease', 'stable disease', 'partial response', and 'complete response'. Combining the two 'non-response' categories, as is common, yields counts C 1 = (11,2,2) and C 2 = (7,7,6) in the two groups.…”

Section: Rank Correlation Testsmentioning

confidence: 99%

Vol. 1, No. 2 (Full Issue)

2002

J. Mod. App. Stat. Meth.

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Recurrent ovarian carcinoma: Salvage treatment with platinum in patients responding to first-line platinum-based regimens

Cited by 4 publications

References 7 publications

Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?

Can adjuvant chemotherapy improve the prognosis of adult ovarian granulosa cell tumors?

Prognostic Factors of Granulosa Cell Tumors: A Retrospective Study in a Tertiary Care Cancer Centre of Eastern India

Vol. 1, No. 2 (Full Issue)

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