Interval versus primary tumor debulking surgery in advanced ovarian cancer: Analysis of the European OVCAD data.
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Le résumé fourni par la source
5071 Background: The international scenery around optimal primary treatment of advanced ovarian cancer (AOC) patients (pts) is currently being discussed, with large discrepancies and heterogeneity still existing between the national guidelines worldwide. Aim of the present study was to evaluate the differences in outcome of AOC-pts after primary (PDS) versus interval-debulking-surgery (IDS) based on a prospectively assessed multicenter data set. Methods: Overall outcome was analyzed from the OVCAD database; a prospective, observational, multicenter project. AOC-pts who underwent surgery in five specialized gynecological cancer centers across three European countries between 02/2005 and 12/2008 were evaluated. Overall (OS) and progression free survival (PFS) were calculated by Kaplan-Meier-curves. Univariate and Cox-regression-analysis were applied. Results: Overall, 256 AOC pts (FIGO-stage III/IV) were evaluated. Fifty pts (19.5%) underwent IDS and 206 pts (80.5%) PDS. Despite the non-randomized setting both groups were well balanced in terms of FIGO-stage, grading, histological subtype and presence of ascites. Different selection criteria were however present for each center. PDS pts presented significantly higher rates of intestinal resection (44.2% vs.24%; p=0.01) and lymphonodectomy compared to IDS ones (72.3%vs.48%; p=0.001), by equivalent complete tumor resection rates (67.5% vs.68%; p=0.82). Platinum response was significantly higher in PDS vs. IDS pts (80.6% vs. 54%; p<0.001). 3-years OS was with 66.7% (95%CI: 60.2-73.2%) significantly better in PDS- versus 48.3% (95%CI: 34.2-62.5%) in IDS pts (p<0.001). Also 2-years PFS was with 31.9% (95%CI:24.8-39.1%) significantly higher in PDS- vs. 11.4% (95%CI: 0.9-22%) in IDS-pts (p<0.001). In multivariate analysis PDS, but not age, ascites, FIGO-stage, grading, histology or residual tumor were of prognostic significance for platinum response. In addition, multivariate analysis identified PDS and no residual tumor to positively and ascites to negatively affect OS and PFS. Conclusions: PDS appears to be associated with a more favorable outcome compared to IDS in highly specialized centers according to this non-randomized data set.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Interval versus primary tumor debulking surgery in advanced ovarian cancer: Analysis of the European OVCAD data.
- Date Crossref
- 20/05/2012
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Charité - Universitätsmedizin Berlin pays non établi dans la noticeÉtablissement de santé
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Universitair Ziekenhuis Leuven pays non établi dans la noticeÉtablissement de santé
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KU Leuven pays non établi dans la noticeUniversité ou école supérieure
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Medical University of Vienna Department of Obstetrics and Gynecology pays non établi dans la noticeUniversité ou école supérieure
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Comprehensive Cancer Center Vienna pays non établi dans la noticeÉtablissement de santé
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Innsbruck Medical University Department of Obstetrics and Gynecology pays non établi dans la noticeUniversité ou école supérieure
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Universität Hamburg pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Hamburg-Eppendorf pays non établi dans la noticeÉtablissement de santé
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Ludwig Boltzmann Institute for Cardiovascular Research pays non établi dans la noticeStructure de recherche
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Charité University Department of Gynecology pays non établi dans la noticeUniversité ou école supérieure
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Katholieke Universiteit Leuven Department of Obstetrics and Gynaecology pays non établi dans la noticeUniversité ou école supérieure
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University Hospitals Leuven KUL pays non établi dans la noticeUniversité ou école supérieure
Charité - Universitätsmedizin Berlin, Universitair Ziekenhuis Leuven et KU Leuven, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.