Multidisciplinary approach in the management of advanced ovarian cancer patients: A personalized approach. Results from a specialized ovarian cancer unit.


OBJECTIVE:The aim of the present study was to evaluate the impact of a multidisciplinary approach in patients' selection with advanced ovarian cancer (AOC) for different therapeutic strategies. METHODS:Patients referred at our institution between 2009 and 2012 for AOC were included. Primary multidisciplinary evaluation was performed in all patients. Different strategies included: 1. patients referred to primary neoadjuvant chemotherapy (NACT) and interval surgery (IDS) (group A); 2. patients considered for surgical exploration. After surgical exploration, patients were either considered for primary debulking (PDS; group B), or NACT (group C). RESULTS:A total of 363 patients were included. Of 38 patients (10.5%) in group A, 24 (63%) had sovradiaphragmatic/multiple liver metastases; 14 (37%) were excluded for PDS for anestehesiologic/medical reasons. Of 325 (89.5%) considered for surgical exploration, 295 (91%; group B) had primary surgery with debulking intent (N: 277) and were cytoreduced to no macroscopic disease (R0: N:200; 68%) o minimal RD<5mm (R1: N:77; 26%) or palliative intent (N:18; 6%); 30 (9%; group C) were referred for NACT. Of those, 27 (90%) underwent IDS, 3 had progressive disease. Overall survival (OS) and progression free survival (PFS) was different between the groups: OS: Group A: 34months; Group B: 59months; Group C: 29months; p<0.001. PFS: Group A: 10months; Group B; 21months; Group C: 12months; p<0.001. CONCLUSIONS:A multidisciplinary approach to patients referred to a tertiary center with AOC allows optimization of the treatment strategy, based on patients' characteristics (age, performance/nutritional status, comorbidities, functional status) and tumor diffusion (evaluated pre- and intraoperatively).


Gynecol Oncol


Gynecologic oncology


Aletti GD,Garbi A,Messori P,Achilarre MT,Zanagnolo V,Rizzo S,Alessi S,Bocciolone L,Landoni F,Biffi R,Carinelli S,Colombo N,Maggioni A




Has Abstract


2017-03-01 00:00:00














  • Update on novel therapeutic agents for cervical cancer.

    abstract::Effective cytotoxic treatment options for advanced cervical cancer are exceedingly limited. Cisplatin-based combination chemotherapy, the most commonly used cytotoxic therapy, has produced response rates ranging from 20% to 30% and overall survival of less than 10 months. Because of the minimal degree of success with ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: del Campo JM,Prat A,Gil-Moreno A,Pérez J,Parera M

    更新日期:2008-09-01 00:00:00

  • Sentinel node mapping vs. lymphadenectomy in endometrial cancer: A systematic review and meta-analysis.

    abstract::Sentinel node mapping is increasingly being utilized for endometrial cancer staging. However, only limited evidence supporting the adoption of sentinel node mapping instead of conventional lymphadenectomy is still available. Here, we aimed to review the current evidence comparing sentinel node mapping and lymphadenect...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,meta分析


    authors: Bogani G,Murgia F,Ditto A,Raspagliesi F

    更新日期:2019-06-01 00:00:00

  • Bcl-X(L) is functionally non-equivalent for the regulation of growth and survival in human ovarian cancer cells.

    abstract:OBJECTIVE:To investigate the role of Bcl-X(L) on the growth and survival of human ovarian carcinoma cells. METHODS:In this study, we enforced down-regulation of Bcl-X(L) by RNA interference in ovarian carcinoma cell lines CaOV3, SKOV3ip1 and OVCAR3 cell lines expressing various levels of Bcl-X(L). We also established ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Dodier P,Piché A

    更新日期:2006-02-01 00:00:00

  • Primary appendiceal malignancy mimicking advanced stage ovarian carcinoma: a case series.

    abstract:BACKGROUND:Primary appendiceal malignancy metastatic to the ovaries is a rare condition that may mimic late stage ovarian cancer. This condition is rarely diagnosed preoperatively. CASES:Three patients referred to our institution from 1994 to 1999 for presumed late stage ovarian cancer were found to have primary appen...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: McBroom JW,Parker MF,Krivak TC,Rose GS,Crothers B

    更新日期:2000-09-01 00:00:00

  • Endocervical curettage: does it contribute to the management of patients with abnormal cervical cytology?

    abstract::Routine endocervical curettage has been advocated in the colposcopic evaluation of patients with abnormal cervical cytology. To assess the usefulness of this procedure, we reviewed the records of 518 patients referred to the Colposcopy Clinic with abnormal Pap smears. Data was reviewed retrospectively in 411 patients ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Oyer R,Hanjani P

    更新日期:1986-10-01 00:00:00

  • Metabolic monitoring of advanced uterine cervical cancer neoadjuvant chemotherapy by using [F-18]-Fluorodeoxyglucose positron emission tomography: preliminary results in three patients.

    abstract:OBJECTIVE:The aim of this report is to describe the potential clinical utility of tracer [F-18]-Fluorodeoxyglucose (FDG) uptake, quantitated as a standardized uptake value (SUV) by positron emission tomography (PET), to evaluate treatment response to neoadjuvant chemotherapy (NAC) in advanced uterine cervical cancer. ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Yoshida Y,Kurokawa T,Kawahara K,Yagihara A,Tsuchida T,Okazawa H,Fujibayashi Y,Yonekura Y,Kotsuji F

    更新日期:2004-12-01 00:00:00

  • Durability of clinical performance afforded by self-collected HPV testing: A 15-year cohort study in China.

    abstract:OBJECTIVE:Self-collected HPV testing could substantially reduce disparities in cervical cancer screening, with slightly lower sensitivity compared to physician-collected specimens cross-sectionally. We aimed to evaluate the comprehensive long-term performance of self-collected HPV testing prospectively. METHODS:In 199...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Zhang L,Xu XQ,Hu SY,Chen F,Zhang X,Pan QJ,Zhang WH,Feng RM,Dong L,Zhang Q,Ma JF,Sauvaget C,Zhao FH,Qiao YL,Sankaranarayanan R

    更新日期:2018-11-01 00:00:00

  • Frailty: an outcome predictor for elderly gynecologic oncology patients.

    abstract:OBJECTIVES:The objective of this pilot study was to determine if frailty predicts surgical complications among elderly women undergoing gynecologic oncology procedures. METHODS:A cohort of gynecologic oncology patients age ≥ 65, undergoing surgery between March and December 2011 was identified. Frailty was evaluated u...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Courtney-Brooks M,Tellawi AR,Scalici J,Duska LR,Jazaeri AA,Modesitt SC,Cantrell LA

    更新日期:2012-07-01 00:00:00

  • Phase 2 trial of single-agent gemcitabine in platinum-paclitaxel refractory ovarian cancer.

    abstract:OBJECTIVE:There is a need to find agents with activity in platinum and taxane refractory ovarian cancer to be employed as second-line therapy in the malignancy. Limited clinical trial experience has suggested that gemcitabine possesses activity in this clinical setting. We wished to further define the level of activity...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Markman M,Webster K,Zanotti K,Kulp B,Peterson G,Belinson J

    更新日期:2003-09-01 00:00:00

  • Retroperitoneal lymphatic involvement with epithelial ovarian tumors of low malignant potential.

    abstract::A comprehensive understanding of retroperitoneal lymphatic involvement is lacking in tumors of low malignant potential. This study was undertaken to evaluate retroperitoneal lymphatic involvement in patients with ovarian tumors of low malignant potential. One hundred seventy-one patients were diagnosed with epithelial...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Leake JF,Rader JS,Woodruff JD,Rosenshein NB

    更新日期:1991-08-01 00:00:00

  • Effect of cervical disease history on outcomes of women who have a pap diagnosis of atypical glandular cells of undetermined significance.

    abstract:OBJECTIVE:To determine the relationship between history of cervical dysplasia or carcinoma and the development of cervical dysplasia or adenocarcinoma in women who have a diagnosis of atypical glandular cells of undetermined significance (AGUS), favor endocervical origin, or AGUS, not otherwise specified. METHODS:A 6-...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Raab SS,Bishop NS,Zaleski MS

    更新日期:1999-09-01 00:00:00

  • Characterization of peripheral blood and ovarian cancer-infiltrating lymphocytes: effect of HIV infection on phenotypic expression and proliferative response.

    abstract::A study that focused on the identification of the phenotype and proliferative responses of peripheral blood and ovarian cancer-infiltrating lymphocytes in a patient with stage III ovarian cancer who had human immunodeficiency virus infection is presented. Monoclonal antibodies and flow cytometry were used to determine...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Guidozzi F,Reddy S,Wadee A

    更新日期:1994-05-01 00:00:00

  • Bilateral ultrastaging of sentinel lymph node in cervical cancer: Lowering the false-negative rate and improving the detection of micrometastasis.

    abstract:OBJECTIVE:To evaluate the sensitivity of sentinel node (SN) ultrastaging and to define parameters that may reduce the overall false-negative rate in women with early-stage cervical cancer. METHODS:We analyzed data from a large retrospective multicenter cohort group with FIGO stages IA-IIB cervical cancer in whom at le...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,多中心研究


    authors: Cibula D,Abu-Rustum NR,Dusek L,Slama J,Zikán M,Zaal A,Sevcik L,Kenter G,Querleu D,Jach R,Bats AS,Dyduch G,Graf P,Klat J,Meijer CJ,Mery E,Verheijen R,Zweemer RP

    更新日期:2012-12-01 00:00:00

  • Gonadotropin stimulation of MLS human epithelial ovarian carcinoma cells augments cell adhesion mediated by CD44 and by alpha(v)-integrin.

    abstract:OBJECTIVE:The goal of this work was to evaluate the involvement of gonadotropins in the regulation of adhesion of human epithelial ovarian carcinoma. We studied two pathways that were previously implicated in the metastatic implantation of ovarian carcinoma to the peritoneum, namely hyaluronan-CD44 and RGD-integrin med...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Schiffenbauer YS,Meir G,Maoz M,Even-Ram SC,Bar-Shavit R,Neeman M

    更新日期:2002-02-01 00:00:00

  • Tamoxifen and the risk of ovarian cancer in BRCA1 mutation carriers.

    abstract:OBJECTIVE:BRCA1 mutation carriers have a high rate of both breast and ovarian cancer. Tamoxifen is a selective estrogen receptor modulator (SERM), which is used for the treatment of primary breast cancer and for the prevention of contralateral breast cancer. Our objective is to assess if tamoxifen treatment is associat...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Vicus D,Rosen B,Lubinski J,Domchek S,Kauff ND,Lynch HT,Isaacs C,Tung N,Sun P,Narod SA,Hereditary Ovarian Cancer Clinical Study Group.

    更新日期:2009-10-01 00:00:00

  • Cardiac metastasis from carcinoma of the cervix: report of two cases.

    abstract:BACKGROUND:The presence of cardiac metastasis from cervical carcinoma is extremely rare. The diagnosis is made almost exclusively postmortem. There are few cases of premortem diagnosis, and it is believed that when cardiac metastasis are found in vivo, the prognosis is extremely poor. Due to the rarity of this conditio...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: Lemus JF,Abdulhay G,Sobolewski C,Risch VR

    更新日期:1998-06-01 00:00:00

  • Ovarian cancer tumor infiltrating T-regulatory (T(reg)) cells are associated with a metastatic phenotype.

    abstract:OBJECTIVE:The objective of this study was to examine the clinicopathologic correlates of T-regulatory (T(reg)) cell infiltration in serous ovarian cancers and to define gene signatures associated with high T(reg)s. METHODS:Tumor infiltrating T(reg) and cytotoxic T-cells (CTLs) were quantitated in 232 primary serous ov...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Barnett JC,Bean SM,Whitaker RS,Kondoh E,Baba T,Fujii S,Marks JR,Dressman HK,Murphy SK,Berchuck A

    更新日期:2010-03-01 00:00:00

  • Push-pull theory: using mechanotransduction to achieve tissue perfusion and wound healing in complex cases.

    abstract::Wound healing has evolved from gauze therapy to the use of proteomics, gene therapy, and cellular-based therapies in the short time span of 45 years. Education for health care providers has not kept pace with the logarithmic acceleration in technology development and treatment options. A patient with a non-healing wou...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: Ennis WJ,Meneses P,Borhani M

    更新日期:2008-11-01 00:00:00

  • Role of hysterectomy in management of gestational trophoblastic disease.

    abstract:OBJECTIVE:To evaluate incidence, indications, and outcome of hysterectomy in women presenting with gestational trophoblastic disease. METHODS:A prospective observational study using a standardized protocol for registration, assessment, and treatment of gestational trophoblastic disease. A total of 5976 consecutive new...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Pisal N,North C,Tidy J,Hancock B

    更新日期:2002-11-01 00:00:00

  • Cell proliferation in ovarian carcinoma: superior accuracy of S-phase fraction (SPF) by DNA labeling index versus flow cytometric SPF, lack of independent prognostic power for SPF and DNA ploidy, and limited effect of SPF on tumor growth rate.

    abstract:OBJECTIVES:The goal of this work was to test the hypotheses that S-phase fraction (SPF) by DNA labeling index (SPF-LI) would predict the course of the disease for ovarian/peritoneal carcinomas and that SPF-LI would correlate better with pathologic classification and outcome than SPF by DNA flow cytometry (SPF-F). METH...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Meyer JS,Gersell DJ,Yim S

    更新日期:2001-06-01 00:00:00

  • Abnormal cervical cytology leading to the diagnosis of gastric cancer.

    abstract::There have been nine cases reported in the English literature in which the finding of malignant cells on cervical/vaginal cytology led to the diagnosis of primary gastric cancer. We report on a patient with gastric carcinoma, metastatic to the cervix, in which the diagnosis was suspected by the finding of signet ring ...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,评审


    authors: McGill F,Adachi A,Karimi N,Wadler S,Kim ES,Greston WM,Kleiner GJ

    更新日期:1990-01-01 00:00:00

  • Cost-effectiveness of adding bevacizumab to first line therapy for patients with advanced ovarian cancer.

    abstract:OBJECTIVE:To evaluate, from a societal perspective, the cost-effectiveness of adding bevacizumab to first-line therapy based on outcomes from the GOG-218 and ICON-7 trials. METHODS:A three-state Markov model was used. The time horizon was until the death of 99% of the initial cohort of 1000 individuals. Costs and qual...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Mehta DA,Hay JW

    更新日期:2014-03-01 00:00:00

  • A phase II trial of didemnin B (NSC No. 325319) in advanced and recurrent cervical carcinoma: a Gynecologic Oncology Group study.

    abstract::Didemnin B was administered to 24 women with recurrent squamous cell cervical carcinoma. The initial dose was 4.2 mg/m2, intravenously, repeated every 28 days. Twenty-three patients were evaluable for toxicity and twenty-one for response. Toxicity was mild, consisting mainly of nausea and vomiting. There were no objec...

    journal_title:Gynecologic oncology

    pub_type: 临床试验,杂志文章


    authors: Jacobs AJ,Blessing JA,Munoz A

    更新日期:1992-03-01 00:00:00

  • p53 allelotypes and enhanced detection of allelic loss in ovarian cancer: lack of correlation with familial and clinical factors.

    abstract::To develop a mapping strategy for improved detection of p53 allelic loss associated with ovarian carcinoma, we utilized multiple intragenic polymorphisms and single-strand conformation polymorphism (SSCP) analysis. p53 allelotype distributions were defined for 80 ovarian cancer patients from germ-line DNA. All polymor...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Skilling JS,Powills K,Lager DJ,Anderson B,Sorosky J,Buller RE

    更新日期:1996-05-01 00:00:00

  • Management of cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia: lessons from the field.

    abstract:OBJECTIVE:We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia. METHODS:We established criteria for patient referral, developed a training program for loop elect...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Pfaendler KS,Mwanahamuntu MH,Sahasrabuddhe VV,Mudenda V,Stringer JS,Parham GP

    更新日期:2008-09-01 00:00:00

  • Identification of inguinofemoral lymph node metastases by methylation markers in vulvar cancer.

    abstract:OBJECTIVE:Lymph node status in early-stage vulvar cancer can be accurately assessed by the sentinel-node (SN) procedure. Molecular techniques, such as DNA-methylation assay, might improve SN assessment. In this study, we selected methylation markers for vulvar cancer and determined if these methylation markers were sui...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Oonk MH,Eijsink JJ,Volders HH,Hollema H,Wisman GB,Schuuring E,van der Zee AG

    更新日期:2012-05-01 00:00:00

  • Adjunctive hysterectomy following radiation therapy for bulky carcinoma of the uterine cervix: prognostic implications of tumor persistence.

    abstract::Twenty-five patients underwent adjunctive extrafascial hysterectomy 14-60 days following completion of external and intracavitary irradiation for bulky carcinoma of the uterine cervix. Review of the operative histopathology and correlation with subsequent patient outcomes suggests that morphologically persistent cance...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Russell AH,Burt AR,Ek M,Russell KJ,Cain JM,Greer BE,Tamimi HK,Figge DC

    更新日期:1987-10-01 00:00:00

  • Detection of disseminated tumor cells in patients with gynecological cancers.

    abstract:OBJECTIVES:The presence of disseminated tumor cells (DTC) in breast cancer patients is associated with poor prognosis. However, there are limited data about the prevalence and prognostic impact of DTC in patients with gynecological tumors. The aim of this study was to evaluate the presence of DTC in the bone marrow (BM...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Fehm T,Becker S,Bachmann C,Beck V,Gebauer G,Banys M,Wallwiener D,Solomayer EF

    更新日期:2006-12-01 00:00:00

  • The value of surgical staging in patients with apparent early stage epithelial ovarian carcinoma.

    abstract:OBJECTIVE:The value of surgical staging of apparent early stage epithelial ovarian carcinoma (EOC) is unclear. The aim of this study was to evaluate the importance of surgical staging on the stage of disease and treatment plan. MATERIAL AND METHODS:All patients with apparent stage I EOC undergoing staging from 01/01/2...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章,多中心研究


    authors: Hengeveld EM,Zusterzeel PLM,Lajer H,Høgdall CK,Rosendahl M

    更新日期:2019-08-01 00:00:00

  • The opioid growth factor (OGF) and low dose naltrexone (LDN) suppress human ovarian cancer progression in mice.

    abstract:OBJECTIVE:The opioid growth factor (OGF) and its receptor, OGFr, serve as a tonically active inhibitory axis regulating cell proliferation in normal cells and a variety of cancers, including human ovarian cancer. Blockade of OGF and OGFr with the nonselective opioid receptor antagonist naltrexone (NTX) upregulates expr...

    journal_title:Gynecologic oncology

    pub_type: 杂志文章


    authors: Donahue RN,McLaughlin PJ,Zagon IS

    更新日期:2011-08-01 00:00:00