Trends in extent of surgical cytoreduction for patients with ovarian cancer

Wong, Deanna H.; Mardock, Alexandra L.; Manrriquez, Erica; Lai, Tiffany; Sanaiha, Yas; Sinno, Abdulrahman K.; Benharash, Peyman; Cohen, Joshua G.

doi:10.1371/journal.pone.0260255

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…Optimal cytoreduction is consistently one of the strongest predictors of overall survival in the platinum-based chemotherapy era [ 9 , 10 , 11 , 12 , 13 , 47 ]. There are several clinical factors known to affect the extent of surgical debulking, including surgical training and patient’s performance status [ 13 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Integrated Clinical and Genomic Models to Predict Optimal Cytoreduction in High-Grade Serous Ovarian Cancer

Cardillo

Devor

Nobre

et al. 2022

Cancers

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Advanced high-grade serous (HGSC) ovarian cancer is treated with either primary surgery followed by chemotherapy or neoadjuvant chemotherapy followed by interval surgery. The decision to proceed with surgery primarily or after chemotherapy is based on a surgeon’s clinical assessment and prediction of an optimal outcome. Optimal and complete cytoreductive surgery are correlated with improved overall survival. This clinical assessment results in an optimal surgery approximately 70% of the time. We hypothesize that this prediction can be improved by using biological tumor data to predict optimal cytoreduction. With access to a large biobank of ovarian cancer tumors, we obtained genomic data on 83 patients encompassing gene expression, exon expression, long non-coding RNA, micro RNA, single nucleotide variants, copy number variation, DNA methylation, and fusion transcripts. We then used statistical learning methods (lasso regression) to integrate these data with pre-operative clinical information to create predictive models to discriminate which patient would have an optimal or complete cytoreductive outcome. These models were then validated within The Cancer Genome Atlas (TCGA) HGSC database and using machine learning methods (TensorFlow). Of the 124 models created and validated for optimal cytoreduction, 21 performed at least equal to, if not better than, our historical clinical rate of optimal debulking in advanced-stage HGSC as a control. Of the 89 models created to predict complete cytoreduction, 37 have the potential to outperform clinical decision-making. Prospective validation of these models could result in improving our ability to objectively predict which patients will undergo optimal cytoreduction and, therefore, improve our ovarian cancer outcomes.

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Section: Discussionmentioning

confidence: 99%

Integrated Clinical and Genomic Models to Predict Optimal Cytoreduction in High-Grade Serous Ovarian Cancer

Cardillo

Devor

Nobre

et al. 2022

Cancers

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“…For ovarian cancer patients at stage IV, due to spread of disease beyond the ovary, the treatment is more challenging ( 28 ). Surgery was regarded as a vital part in the treatment of ovarian cancer patients ( 29 , 30 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction for 2-year mortality of metastatic ovarian cancer patients based on surveillance, epidemiology, and end results database

Wang

Xue

et al. 2022

Front. Surg.

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AimTo establish prediction models for 2-year overall survival of ovarian cancer patients with metastasis.MethodsIn total, 4,929 participants from Surveillance, Epidemiology, and End Results (SEER) database were randomly divided into the training set (n = 3,451) and the testing set (n = 1,478). Univariate and multivariable regression were conducted in the training set to identify predictors for 2-year overall survival of metastatic ovarian cancer patients. The C-index was calculated for assessing the performance of the models. The nomogram for the model was plotted. The prediction value of the model was validated in the testing set. Subgroup analysis were performed concerning surgery and chemotherapy status of patients and the metastatic site of ovarian cancer in the testing set. The calibration curves were plotted and the decision curve analysis (DCA) were conducted.ResultsAt the end of follow-up, 2,587 patients were survived and 2,342 patients were dead within 2 years. The 2-year survival rate was 52.5%. The prediction models were constructed based on predictors including age, radiation, surgery and chemotherapy, CA125, and bone, liver, and lung metastasis. The prediction model for 2-year overall survival of ovarian cancer patients with metastasis showed good predictive ability with the C-index of the model of 0.719 (95% CI: 0.706–0.731) in the training set and 0.718 (95% CI: 0.698–0.737) in the testing set. In terms of patients with bone metastasis, the C-index was 0.740 (95% CI: 0.652–0.828) for predicting the 2-year overall survival of ovarian cancer patients. The C-index was 0.836 (95% CI: 0.694–0.979) in patients with brain metastasis, 0.755 (95% CI: 0.721–0.788) in patients with liver metastasis and 0.725 (95% CI: 0.686–0.764) in those with lung metastasis for predicting the 2-year overall survival of ovarian cancer patients.ConclusionThe models showed good predictive performance for 2-year overall survival of metastatic ovarian cancer patients.

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“…So sind Patientinnen beispielsweise auf der Grundlage bildgebender pathologischer Befunde präoperativ nicht immer sicher einer Fachrichtung zuzuordnen [ 26 , 33 ]. Zudem kann auch intraoperativ eine interdisziplinäre Kooperation indiziert sein [ 22 , 96 ]. Weiterhin können intra- sowie postoperative Komplikationen das Hinzuziehen von KollegInnen anderer Fachrichtungen notwendig machen [ 94 ].…”

Section: Hintergrundunclassified

“…Insgesamt wird bei etwa 22 % der Patientinnen mit operativ therapiertem Ovarialkarzinom eine extensive Op mit Involvierung der abdominellen Organe nötig [ 96 ]. Abb.…”

Section: Ergebnisse (Eckpunkte)unclassified

Interdisziplinär ausgerichtetes Operationsspektrum in Kooperation von Viszeralchirurgie und Gynäkologie

Garlaschelli,

Ignativ,

Meyer

2024

Chirurgie

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Zusammenfassung Ziel Die vorliegende Kurzübersicht soll in prägnanter Form aus bevorzugt operativer Sicht die wichtigsten gynäkologischen Fragestellungen erläutern, welche auch für Allgemein- und ViszeralchirurgInnen relevant sein können, sowie wesentliche gynäkologische Aspekte primär viszeralchirurgischer Krankheitsbilder aufzeigen. Methode Narrative Übersicht zum Thema der gynäkologisch/allgemein- und viszeralchirurgischen interdisziplinären Kooperation mithilfe von PubMed® sowie der Cochrane Llibrary unter Verwendung von Suchbegriffen wie „operative profile of abdominal surgery and gynecology“, „interdisciplinary surgery aspects of gynecology/abdominal surgery“ sowie „interdisciplinary surgical approach – surgical complication“. Ergebnisse (Eckpunkte) Viele primär gynäkologische Krankheitsbilder können, allein durch die engen anatomischen Verhältnisse, auch an abdominellen Organen auftreten. Ebenso können primär viszeralchirurgische Pathologien auch eine Involvierung der gynäkologischen Organe bedingen. Hierdurch kann eine intraoperative Zusammenarbeit notwendig werden. Auch prä- und postoperativ kann aufgrund diagnostischer Unsicherheit oder im Rahmen von Komplikationen eine Interdisziplinarität gefordert sein. Dabei können ein fächerübergreifendes Wissen der therapierenden ÄrztInnen sowie die enge Kooperation der gefragten Fachrichtungen das Outcome der betroffenen Patientinnen verbessern. Schlussfolgerung Viele Krankheitsbilder erstrecken sich nicht nur bis an die Grenze der einzelnen Fachbereiche, sondern können darüber hinaus auch weitere Systeme betreffen. Für eine optimale Therapie ist es daher notwendig, auch solche Aspekte der Pathologien zu kennen sowie strukturierte Abläufe der interdisziplinären Kooperation zu etablieren.

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Trends in extent of surgical cytoreduction for patients with ovarian cancer

Cited by 5 publications

References 32 publications

Integrated Clinical and Genomic Models to Predict Optimal Cytoreduction in High-Grade Serous Ovarian Cancer

Integrated Clinical and Genomic Models to Predict Optimal Cytoreduction in High-Grade Serous Ovarian Cancer

Prediction for 2-year mortality of metastatic ovarian cancer patients based on surveillance, epidemiology, and end results database

Interdisziplinär ausgerichtetes Operationsspektrum in Kooperation von Viszeralchirurgie und Gynäkologie

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