Abstract:
BACKGROUND:Diaphragm involvement by ovarian cancer is often considered to be a major obstacle to successful cytoreductive surgery. Lack of evidence of survival benefit, concerns over safety and lack of experience are common justifications for this belief. In this study, we sought to evaluate the therapeutic value of diaphragmatic surgery in advanced ovarian cancer. METHODS:Relevant data from all consecutive patients with stage IIIC and IV epithelial ovarian cancer, primarily operated at Mayo Clinic from 1994 through 1998, were collected and analyzed. Statistical analyses were performed using chi(2) test, Cox regression model and Kaplan-Meier curves including log rank test. For comparison of trends in performing procedures, an additional 91 consecutive patients undergoing surgery from August 1, 2002 and August 31, 2004 were analyzed. RESULTS:244 eligible patients were identified. Mean age was 64 years (range: 24-87), and 5-year overall survival (OS) was 31.5%. For the entire cohort, residual disease (RD) was the only independent prognostic factor in multivariate analysis (P < 0.0001) when considering other factors including demographic, intraoperative findings and procedures performed. For the subgroup of patients with tumor involving the diaphragm (N = 181), patients who underwent diaphragm surgery (stripping of the diaphragmatic peritoneum, full or partial thickness diaphragm resection, excision of nodules or CUSA) had improved 5-year OS relative to those that did not (53% vs. 15%; P < 0.0001). Furthermore, in multivariate analysis of patients with diaphragm disease, both RD and performance of diaphragm surgery were independent predictors of outcome (P < 0.001). Considering the subgroup of patients with RD < 1 cm, we noted a strong survival advantage for those patients who underwent diaphragm surgical procedures (5-year survival: 55% vs. 28%; P = 0.0005). Over time, we noted a statistically significant increase in the rate of diaphragm procedures for patients with diaphragm involvement from 1994-98 relative to 2002-3 (22.5% vs. 40%: P = 0.022). CONCLUSIONS:Surgical procedures to treat diaphragm disease increase the rate of complete and optimal debulking and correlate with improved survival even compared to patients optimally debulked without diaphragm surgery performed.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Aletti GD,Dowdy SC,Podratz KC,Cliby WAdoi
10.1016/j.ygyno.2005.08.027subject
Has Abstractpub_date
2006-02-01 00:00:00pages
283-7issue
2eissn
0090-8258issn
1095-6859pii
S0090-8258(05)00720-1journal_volume
100pub_type
杂志文章abstract::Human papillomaviruses (HPVs) are small double-stranded DNA viruses that infect the skin and internal squamous mucosae. These viruses were once considered to be the causal agent only of skin or genital warts--lesions of trivial significance. It turns out, however, that HPVs belong to a large virus family that includes...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2010.04.002
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:Ovarian cancer remains a leading cause of death in women and development of new therapies is essential. Second mitochondria derived activator of caspase (Smac) has been described to sensitize for apoptosis. We have explored the proapoptotic activity of a small molecule mimic of Smac/DIABLO on ovarian cancer ...
journal_title:Gynecologic oncology
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doi:10.1016/j.ygyno.2007.01.011
更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.03.101
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abstract::Cancers with deficiencies in homologous recombination-mediated DNA repair (HRR) demonstrate improved clinical outcomes and increased survival. Approximately 50% of high-grade serous ovarian cancers (HGSOC) exhibit homologous recombination deficiency (HRD). HRD can be caused by germline or somatic mutations of genes in...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2020.08.035
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate tumor control, survival, and toxic effects in patients with International Federation of Gynecology and Obstetrics (1988) stage I-IIIA papillary serous carcinoma of the endometrium treated with concurrent chemoradiation and adjuvant chemotherapy. METHODS:Thirty-two patients were enro...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.01.025
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:While there is ample literature on prognostic factors for uterine cancer, currently there are nomeans to estimate an individual's risk for recurrence or to differentiate the risk of loco-regional recurrence from distant recurrence. We addressed this gap by developing nomograms to individualize the risk of rec...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.02.022
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this case-controlled study was to determine the prevalence of anemia and incidence of perioperative blood transfusions in patients undergoing treatment for advanced ovarian cancer with neoadjuvant chemotherapy (NACT) or primary debulking surgery (PDS). METHODS:We performed a single institution...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.05.014
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To determine if extra-peritoneal laparoscopic para-aortic (PA) lymphadenectomy allows a reliable assessment of PA nodes in patients with endometrial cancer (EC). METHODS:In October of 2005, a single surgeon began performing extra-peritoneal laparoscopic PA lymphadenectomy for patients with EC. A prospective ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2008.08.021
更新日期:2008-12-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.09.018
更新日期:2007-01-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1998.5273
更新日期:1999-03-01 00:00:00
abstract::The proliferative activities (3H-thymidine labeling index, LI) of 72 primary ovarian cancers and 76 metastatic lesions from untreated patients were evaluated. Overall, median LI values for primary and metastatic lesions were similar (7.8 vs 7.0%), but cell kinetics significantly differed in metastases from different s...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0090-8258(89)90003-6
更新日期:1989-10-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ygyno.2011.11.022
更新日期:2012-03-01 00:00:00
abstract::Sixty-eight patients with FIGO stage I, grade 2 or 3 adenocarcinoma of the endometrium were treated according to a protocol involving 10 Gy external pelvic irradiation, prompt hysterectomy with surgical staging, and postoperative therapy individualized according to surgical-pathologic findings. Five-year survival for ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(86)90222-2
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS:Patients from the prospective observational multi-centre study "EMBRACE" were...
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doi:10.1016/j.ygyno.2020.07.007
更新日期:2020-10-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2016.06.004
更新日期:2016-08-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究
doi:10.1006/gyno.2001.6154
更新日期:2001-05-01 00:00:00
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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.2007.02.003
更新日期:2007-05-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5334
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(90)90156-f
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90111-u
更新日期:1992-11-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(89)90106-6
更新日期:1989-07-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2002.6828
更新日期:2002-12-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.12.332
更新日期:2011-04-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/0090-8258(88)90258-2
更新日期:1988-07-01 00:00:00
abstract::Forty patients with locally advanced cervical carcinoma were entered into a protocol utilizing the bolus administration of both mitomycin C (10 or 15 mg) on Day 1 and 5-fluorouracil (400 mg) on Day 1-5 followed by sequential pelvic irradiation on Day 6 between September 1980 and October 1985. All patients had poor-pro...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,评审
doi:10.1006/gyno.1996.0013
更新日期:1996-01-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2010.11.041
更新日期:2011-04-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.07.127
更新日期:2017-10-01 00:00:00
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journal_title:Gynecologic oncology
pub_type: 指南,杂志文章,评审
doi:10.1016/j.ygyno.2020.10.009
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To determine whether written information and/or counseling based on the WOMAN-PRO II Program decreases symptom prevalence in women with vulvar neoplasia by a clinically relevant degree, and to explore the differences between the 2 interventions in symptom prevalence, symptom distress prevalence, and symptom e...
journal_title:Gynecologic oncology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ygyno.2017.04.024
更新日期:2017-07-01 00:00:00