Identification of prognostic factors after positive second-look surgery in epithelial ovarian carcinoma Journal Article
| Authors: | McCreath, W. A.; Eisenhauer, E. L.; Abu-Rustum, N. R.; Venkatraman, E. S.; Caceres, A.; Bier, R.; Huh, J.; Cho, J.; Barakat, R. R.; Chi, D. S. |
| Article Title: | Identification of prognostic factors after positive second-look surgery in epithelial ovarian carcinoma |
| Abstract: | Objective.: The objective of this study was to identify independent prognostic factors for survival in patients with epithelial ovarian cancer who had persistent disease identified at second-look surgery. Methods.: We performed a retrospective chart review of all patients with epithelial ovarian cancer who had positive findings at second-look surgery between June 1991 and June 2002. All patients achieved a complete clinical remission after a prescribed course of primary therapy. Survival was determined from the time of second-look surgery until last follow-up or death. Results.: The study included a total of 262 patients, with a median age of 54 years (range, 22-80). Of the 262 patients, 166 (63%) had died of disease. Records of initial (salvage) treatment after the positive second-look surgery were available for 243 patients. Therapies included the following: intraperitoneal (IP) cisplatin, 71 (29%); IP cisplatin combined with a second drug, 53 (22%); IP therapy other than cisplatin, 29 (12%); intravenous (IV) chemotherapy, 50 (21%); IP and IV therapy, 35 (14%); and oral chemotherapy, 5 (2%). Of the 13 potential prognostic factors analyzed, only 2 factors emerged that, when combined, were significant-residual disease after primary surgery and size of persistent disease found at second-look surgery. Patients with ≤1 cm residual disease after primary surgery and microscopic disease at second-look surgery had significantly improved survival. Conclusion.: In our analysis, the only prognostic factor for survival in patients with positive second-look procedures was a combination of residual disease after primary surgery and size of persistent disease identified at second-look surgery. No individual chemotherapy treatment imparted a survival advantage. Novel that therapeutic approaches are needed in this setting. © 2005 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; controlled study; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; disease course; postoperative period; salvage therapy; cisplatin; doxorubicin; cancer combination chemotherapy; antineoplastic agents; capecitabine; gemcitabine; paclitaxel; topotecan; follow up; ovarian cancer; ovarian neoplasms; carboplatin; tumor volume; etoposide; antineoplastic combined chemotherapy protocols; cyclophosphamide; retrospective study; ifosfamide; cause of death; survival time; cancer regression; minimal residual disease; folinic acid; mitoxantrone; prognostic factors; ovary carcinoma; epithelial cells; platinum; oxaliplatin; floxuridine; second look surgery; infusions, parenteral; injections, intravenous; early intervention; second-look surgery |
| Journal Title: | Gynecologic Oncology |
| Volume: | 102 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2006-07-01 |
| Start Page: | 8 |
| End Page: | 14 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2005.11.040 |
| PUBMED: | 16427689 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 4 June 2012" - "CODEN: GYNOA" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
382Seshan -
4Mccreath -
629Barakat -
707Chi -
888Abu-Rustum -
36
Eisenhauer -
19
Ward -
1
Bier
Related MSK Work