The role of secondary cytoreductive surgery in the treatment of patients with recurrent epithelial ovarian carcinoma

Eisenkop, Scott M.; Friedman, Richard L.; Spirtos, Nick M.

doi:10.1002/(sici)1097-0142(20000101)88:1<144::aid-cncr20>3.3.co;2-o

Cited by 77 publications

(142 citation statements)

References 16 publications

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“…In line with previous reports, removal of all visible tumours at SCS contributed to long-term survival (Figure 2). The rate of complete resection (59.1%) in our series was a little lower than the rates reported by Eisenkop et al (2000), Landoni et al (1998) and Cormio et al (1999). However, in Landoni's study, the subjects were restricted to those patients who were sensitive to first-line chemotherapy and chemotherapy before SCS.…”

Section: Discussioncontrasting

confidence: 58%

“…In most studies, the cutoff period of DFI was set to 12 months. Two cutoff periods were set in Eisenkop's study (Eisenkop et al, 2000) (12 and 36 months) and in Tay's study (Tay et al, 2002) (12 and 24 months), and patients were divided into three groups. Although we also analysed our patients with DFI 412 months using cutoff periods such as 24 and 36 months, there were no significant differences between patients with and without DFI 424 or 36 months (data not shown).…”

Section: Discussionmentioning

confidence: 99%

“…Size of maximum tumour was also identified by Eisenkop et al (2000) as an independent prognostic factor. Eisenkop et al used 10 cm as the cutoff size, whereas we used 6 cm.…”

Section: Discussionmentioning

confidence: 99%

“…One reason is that some studies restricted the subjects for SCS to patients with isolated tumours or a solitary tumour (Cormio et al, 1999;Munkarah et al, 2001;Scarabelli et al, 2001). Another possible reason is that Eisenkop et al (2000) and Tay et al (2002) did not analyse the number of recurrent tumours as a factor influencing survival, although they pointed out that this factor may influence SCS outcome. In concordance with our results, Zang et al (2004) reported that the number of recurrent tumours influenced both overall survival and SCS outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, several investigators have reported the significant value of secondary cytoreductive surgery (SCS) in a subset of patients with recurrent ovarian cancer (Jänicke et al, 1992;Eisenkop et al, 1995Eisenkop et al, , 2000Vaccarello et al, 1995;Cormio et al, 1999;Zang et al, 2000Zang et al, , 2004Munkarah et al, 2001;Scarabelli et al, 2001;Tay et al, 2002). The value of complete resection at the time of SCS for highly selected patients is in consensus in these recent reports.…”

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confidence: 99%

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Secondary cytoreductive surgery for recurrent epithelial ovarian carcinoma: proposal for patients selection

et al. 2005

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The value of secondary cytoreductive surgery (SCS) for recurrent ovarian cancer is still controversial. The aim of this study was to clarify candidates for SCS. Between January 1987 and September 2000, we performed SCS in 44 patients with recurrent ovarian cancer, according to our selection criteria, disease-free interval (DFI) 46 months, performance status o3, no apparent multiple diseases, age o75years and no progressive disease during preoperative chemotherapy, if undertaken. The variables were investigated by univariate and multivariate analyses. Of 44 patients, 26 (59.1%) achieved complete removal of all visible tumours at SCS. Secondary cytoreductive surgery outcome, complete or incomplete resection, was significantly related to overall survival (P ¼ 0.0019). As for variables determined before SCS, DFI 412 months, no liver metastasis, solitary tumour and tumour size o6 cm were independently associated with favourable overall survival after recurrence in the multivariate analysis. Patients with three or all four variables (n ¼ 31) had significantly better survival compared with the other patients (n ¼ 13) (47 vs 20 months in median survival, Po0.0001). In these patients, fairly good median survival (40 months) was obtained even in patients with incomplete resection. Secondary cytoreductive surgery had a large impact on survival of patients with recurrent ovarian cancer when they had three or all of the above-mentioned four factors at recurrence. These patients should be considered as ideal candidates for SCS.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

“…Size of maximum tumour was also identified by Eisenkop et al (2000) as an independent prognostic factor. Eisenkop et al used 10 cm as the cutoff size, whereas we used 6 cm.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Secondary cytoreductive surgery for recurrent epithelial ovarian carcinoma: proposal for patients selection

et al. 2005

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Current management of epithelial ovarian carcinoma: A review

Marsden

Friedlander

Hacker

2000

Semin. Surg. Oncol.

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Epithelial carcinoma of the ovary is the most lethal of gynaecological malignancies and it affects about one in 70 women in developed countries. Over 75% of women with the disease have tumour spread beyond the pelvis at the time of diagnosis, and their treatment requires the appropriate use of surgery and chemotherapy. The strategies used in the treatment of ovarian cancer are constantly evolving. An overview of current treatment regimens and their evolution is provided, with particular emphasis on the interdependence of surgery and chemotherapy in the optimal management of the disease. Semin. Surg. Oncol. 19:11–19, 2000. © 2000 Wiley‐Liss, Inc.

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Cytoreductive surgery plus chemotherapy versus chemotherapy alone for recurrent epithelial ovarian cancer

Galaal

Naik

Bristow

et al. 2010

Cochrane Database of Systematic Reviews

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Background Most women with advanced epithelial ovarian cancer will ultimately develop recurrent disease after completion of initial treatment with primary surgery and adjuvant chemotherapy. Secondary cytoreductive surgery may have survival benefits in selected patients. However, a number of chemotherapeutic agents are active in recurrent ovarian cancer and the standard treatment of patients with recurrent ovarian cancer remains poorly defined. Objectives To evaluate the effectiveness and safety of secondary surgical cytoreduction and chemotherapy compared to chemotherapy alone for women with recurrent epithelial ovarian cancer. Search methods We searched the Cochrane Gynaecological Cancer Group Trials Register, The Cochrane Register of Controlled Trials, (CENTRAL) Issue 1 2009, MEDLINE and EMBASE up to February 2009. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of review articles and contacted experts in the field. Selection criteria We searched for RCTs, quasi-randomised trials and non-randomised studies that compared secondary cytoreductive surgery and chemotherapy to chemotherapy alone in women with recurrent epithelial ovarian cancer. Data collection and analysis Three reviewers independently assessed whether potentially relevant studies met the inclusion criteria. No trials were found and therefore no data were analysed. Main results The search strategy identified 1431 unique references of which all were excluded on the basis of title and abstract. Authors’ conclusions We found no evidence from RCTs to inform decisions about secondary surgical cytoreduction and chemotherapy compared to chemotherapy alone for women with recurrent epithelial ovarian cancer. Ideally, a large randomised controlled trial or, at the very least, well designed non-randomised studies that use multivariate analysis to adjust for baseline imbalances are needed to compare these treatment modalities. The results of the ongoing RCT AGO-OVAR OP.4 (DESKTOP III) is awaited.

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The role of secondary cytoreductive surgery in the treatment of patients with recurrent epithelial ovarian carcinoma

Abstract: presented in poster form at the Society of

Cited by 77 publications

References 16 publications

Secondary cytoreductive surgery for recurrent epithelial ovarian carcinoma: proposal for patients selection

Secondary cytoreductive surgery for recurrent epithelial ovarian carcinoma: proposal for patients selection

Current management of epithelial ovarian carcinoma: A review

Cytoreductive surgery plus chemotherapy versus chemotherapy alone for recurrent epithelial ovarian cancer

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