Is Neo-adjuvant Chemotherapy a "Waiver" of Extensive Upper Abdominal Surgery in Advanced Epithelial Ovarian Cancer?
Summary of "Is Neo-adjuvant Chemotherapy a "Waiver" of Extensive Upper Abdominal Surgery in Advanced Epithelial Ovarian Cancer?"
BACKGROUND:
The goal of this study was to explore the necessity of extensive surgical procedures in patients who received neoadjuvant chemotherapy (NAC).
METHODS:
We analyzed the surgical outcomes and frequency of extensive procedures required for maximal cytoreductive surgery after NAC and primary debulking surgery (PDS) in 256 women with advanced epithelial ovarian cancer.
RESULTS:
NAC was performed in 116 of 256 women (45.3%). In NAC group, complete cytoreduction rate and optimal cytoreduction rate were 60.3 and 92.2%, respectively. Although the NAC group comprised patients with higher risk of suboptimal cytoreduction, complete cytoreduction rate was similar to that of PDS group (57.9%, P = .69). Moreover, blood loss and surgical complexity significantly reduced in NAC group (P = .011 and .017). Extensive upper abdominal surgery (EUAS) was performed in 70 of 116 patients (60.3%) in the NAC group. The frequency of EUAS was similar between NAC and PDS group (P = .60). Among NAC group, gross upper abdominal metastasis requiring EUAS was found in 51 patients (44%, 95% confidence interval = 35.3-53.1%).
CONCLUSIONS:
A significant proportion of patients who received NAC still have gross metastatic tumors requiring EUAS. Gynecologic oncologists should be familiar with EUAS and be ready to perform any required procedures together with multidisciplinary teams, even in the patients who have received NAC.
Affiliation
Gynecologic Oncology Research Division, Uterine Cancer Center, National Cancer Center, Goyang, Republic of Korea, sokbom@ncc.re.kr.
Journal Details
This article was published in the following journal.
Name: Annals of surgical oncology
ISSN: 1534-4681
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21691879
- DOI: http://dx.doi.org/10.1245/s10434-011-1830-0
Medical and Biotech [MESH] Definitions
Chemotherapy, Adjuvant
Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Radiotherapy, Adjuvant
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Abdominal Wound Closure Techniques
Methods to repair breaks in abdominal tissues caused by trauma or to close surgical incisions during abdominal surgery.
Cystaphos
Proposed as an adjuvant to cancer chemotherapy; may have radiation protective properties.
Second-look Surgery
A followup operation to examine the outcome of the previous surgery and other treatments, such as chemotherapy or radiation therapy.
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