Abstract:
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).
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
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 Adoi
10.1016/j.ygyno.2017.01.017subject
Has Abstractpub_date
2017-03-01 00:00:00pages
468-473issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(17)30061-6journal_volume
144pub_type
杂志文章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
doi:10.1016/j.ygyno.2008.04.016
更新日期:2008-09-01 00:00:00
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
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journal_title:Gynecologic oncology
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doi:10.1016/j.ygyno.2005.08.028
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pub_type: 杂志文章,评审
doi:10.1006/gyno.2000.5913
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(86)90100-9
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journal_title:Gynecologic oncology
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doi:10.1016/j.ygyno.2004.08.037
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
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journal_title:Gynecologic oncology
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pub_type: 杂志文章
doi:10.1006/gyno.1999.5512
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1994.1126
更新日期:1994-05-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6512
更新日期:2002-02-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.06.012
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journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
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更新日期:1998-06-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.11.020
更新日期:2010-03-01 00:00:00
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
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更新日期:2008-11-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1996.0122
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.04.031
更新日期:2008-09-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.01.013
更新日期:2012-05-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
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journal_title:Gynecologic oncology
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journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
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更新日期:2019-08-01 00:00:00
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