Primary Cytoreductive surgery (PS) and Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (NACT/IDS) in Advanced Epithelial Ovarian Cancer (EOC): Regional Cancer Centre Experience
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 2
Abstract
Background: The standard treatment of advanced ovarian cancer [FIGO stage 3 and 4] has been complete cytoreductive surgery (CRS) followed by Platinum based chemotherapy. Neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (NACT/IDS) has been considered as an alternative to conventional PS in treating advanced EOC. Objective: Analysis of survival and prognostic factors in advanced EOC patients who underwent Primary Cytoreductive surgery (PS) with Neoadjuvant Chemotherapy (NACT) followed by Interval Debulking Surgery (NACT/IDS) Methods: A retrospective analysis of 25 patients who had advanced EOC surgery (stage 3 & 4) between the years 2005-2009. Clinicopathological, potential prognostic factors and progression-free survival (PFS) were analyzed. Results: No significant difference was seen in the operative time, blood loss among PS and NACT-IDS group. Need for extensive surgeries which included bowel surgeries, diaphragm stripping/ resection, splenectomy, groin node debulking, pelvic/parietal peritonectomy was higher in PS group (53%) when compared to NACT-IDS group (35%). In optimal cytoreductive group, when patients took complete chemotherapy, the median PFS was 21 months and in patients with incomplete chemotherapy it was 10 months(P=0.025). In suboptimal cytoreductive group, when complete chemotherapy was taken ,the median PFS was 24 months when compared to 6 months in those who took incomplete chemotherapy(p=0.001). There was no difference in overall survival. Conclusion: Though in many institutes, Primary debulking surgery is still the gold standard treatment. As long as optimal debulking is feasible in EOC, NACT-IDS can be considered for patients where optimal debulking is not possible or surgery is risky due to various patient related/ tumor related factors
Authors and Affiliations
Dr Rajshekar. S Kunderagi
Keywords
Related Articles
- EP ID EP486757
- DOI -
- Views 48
- Downloads 0
Granular Cell Tumour – Esophagus Presented As Gastric Esophgeal Reflex Disease
Granular cell tumor of esophagus belongs to the category of soft tissue neoplasm and originates from Schwann cells. The tumor predominantly occurs in the oral cavity, breast tissue and skin. Esophageal origin is uncommon...
Upper Extremity Deep Vein Thrombosis (Paget –Von Schroetter Syndrome) - A Rare Case Report
Primary "spontaneous" upper extremity deep vein thrombosis is uncommon and is defined as thrombosis of the deep veins draining the upper extremity due to anatomic abnormalities of the thoracic outlet causing axillosubcla...
Hysteroscopic Evaluation of Abnormal Uterine Bleeding- Vaginoscopic Approach
Introduction: Abnormal uterine bleeding, a common but complicated clinical presentation accounting for almost 20% of gynecologic outpatient visits1, reported 25% of gynecologic surgeries.2Easily accomplished in an office...
Gestational Trophoplastic Disease in Babylon Maternity and Paediatrics Teaching Hospital a Prospective Study
Background: Gestational trophoblastic tumours arise from the cells of conception and form a range of related conditions, from the benign partial mole to the aggressive malignancies of choriocarcinoma and placental site t...
A New Horizon for Better Dental Implants – A Nanotechnological Approach
Current trend in dental implants include use of endosseous dental implant surfaces embellished with nanoscale topographies. The goal of this review is to consider the role of nanoscale topographic modification of titaniu...