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Stage IV ovarian cancer: disease site-specific rationale for postoperative treatment.

Abstract：

OBJECTIVES:We aimed to define the site-specific patterns of treatment failure in stage IV ovarian cancer. METHODS:Data from all consecutive Mayo Clinic patients with stage IV epithelial ovarian cancer, from 1994 through 2003, were collected and analyzed. Statistical analyses included the chi(2) test and Kaplan-Meier curves with log-rank tests. RESULTS:Review of our patient database identified 109 patients with stage IV ovarian cancer: mean age, 62 years (range, 36-83 years); 5-year overall survival, 15%. Most patients (74%) had intraperitoneal disease at the time of relapse, 36% had pleural effusion, and 49% had extraperitoneal metastases. At the time of death 75% had intraperitoneal localizations, 51% had pleural effusion, and 46% had extraperitoneal metastases. Patients with pleural effusion were more likely to have pleural disease at relapse and at last follow-up. Extrapleural disease at the time of diagnosis predicted extrapleural disease at relapse and at last follow-up. Most patients classified as having stage IV disease by pleural cytology only, as opposed to all other patients, had intraperitoneal disease at relapse (88% vs 58.7%, P=.001) and last follow-up (88.5% vs 59.6%, P=.001). Patients having stage IV disease by pleural cytology only had survival benefit when disease was optimally debulked in the abdomen and pelvis (median survival, 3.1 years vs 1.3 years; P=.001). Patients with multiple unresectable liver metastases had poor prognosis (median survival, 1.2 years) owing to progression of liver disease. CONCLUSIONS:Clinical trials for stage IV ovarian cancer should reflect the site-specific risks for recurrence according to disease location at diagnosis.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Aletti GD,Podratz KC,Cliby WA,Gostout BS

doi

10.1016/j.ygyno.2008.09.010

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

22-7

issue

1

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(08)00730-0

journal_volume

112

pub_type

杂志文章

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