paywalled: Gynecologic Oncology Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer

Impact of Complete Cytoreduction Leaving No Gross Residual Disease Associated with Radical Cytoreductive Surgical Procedures on Survival in Advanced Ovarian Cancer

 Abstract

Background  

To analyze the impact of radical cytoreductive surgery—as part of primary tumor debulking—on the amount of residual tumor and survival in patients with advanced ovarian cancer and to evaluate the prognostic significance of no gross residual disease (RD) after surgery.

Methods  

Medical records of 203 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC–IV ovarian cancer were reviewed. All patients underwent primary cytoreductive surgery followed by taxane- and platinum-based chemotherapy. Various clinicopathologic characteristics were collected.

Results  

Of 203 patients, 119 patients underwent simple surgery, while radical surgery was performed in 84 patients..........

Conclusions  

No gross RD is associated with improved overall survival, and radical surgery was effective for achieving no gross RD.

 

paywalled: Early Postoperative CT as a Prognostic Biomarker in Patients With Advanced Ovarian, Tubal, and Primary Peritoneal Cancer Deemed Optimally Debulked at Primary Cytoreductive Surgery

Early Postoperative CT as a Prognostic Biomarker in Patients With Advanced Ovarian, Tubal, and Primary Peritoneal Cancer Deemed Optimally Debulked at Primary Cytoreductive Surgery

CONCLUSION:

Our study showed that residual disease larger than 1 cm was present on early postoperative CT in almost half of the patients deemed to have optimally debulked disease at primary cytoreduction.

abstract: Evolution of surgical treatment paradigms for advanced-stage ovarian cancer: Redefining ‘optimal’ residual disease

Evolution of surgical treatment paradigms for advanced-stage ovarian cancer: Redefining ‘optimal’ residual disease

Abstract:

Over the past 40 years, the survival of patients with advanced ovarian cancer has greatly improved due to the introduction of combination chemotherapy with platinum and paclitaxel as standard front-line treatment and the progressive incorporation of increasing degrees of maximal cytoreductive surgery. The designation of “optimal” surgical cytoreduction has evolved from residual disease ≤ 1 cm to no gross residual disease. There is a growing body of evidence that patients with no gross residual disease have better survival than those with optimal but visible residual disease. In order to achieve this, more radical cytoreductive procedures such as radical pelvic resection and extensive upper abdominal procedures are increasingly performed. However, some investigators still suggest that tumor biology is a major determinant in survival and that optimal surgery cannot fully compensate for tumor biology.
The aim of this review is to outline the theoretical rationale and historical evolution of primary cytoreductive surgery, to re-evaluate the preferred surgical objective and procedures commonly required to achieve optimal cytoreduction in the platinum/taxane era based on contemporary evidence, and to redefine the concept of “optimal” residual disease within the context of future surgical developments and analysis of treatment outcomes.

Highlights

► No gross residual disease is associated with superior survival outcomes for patients with advanced-stage epithelial ovarian cancer.
► Complete cytoreduction should be the preferred surgical objective at the time of initial surgery for advanced-stage epithelial ovarian cancer.

Follow-Up Study of the Correlation Between Postoperative Com... : International Journal of Gynecological Cancer

Follow-Up Study of the Correlation Between Postoperative Computed Tomographic Scan and Primary Surgeon Assessment in Patients With Advanced Ovarian, Tubal, or Peritoneal Carcinoma Reported to Have Undergone Primary Surgical Cytoreduction to Residual Disease of 1 cm or Smaller

Conclusions: On this follow-up analysis, only age, stage, and residual disease were significant prognostic factors for overall survival. Discordant findings between the primary surgeon's assessment and the postoperative CT scan findings of residual disease was not an independent prognostic factor.