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Żak K, Satora M, Skrabalak I, Tarkowski R, Ostrowska-Leśko M, Bobiński M. The Potential Influence of Residual or Recurrent Disease on Bevacizumab Treatment Efficacy in Ovarian Cancer: Current Evidence and Future Perspectives. Cancers (Basel) 2024; 16:1063. [PMID: 38473419 DOI: 10.3390/cancers16051063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
There were high hopes for the new antiangiogenic medicament, bevacizumab, which could inhibit the creation of new blood vessels through binding to isoform A of vascular endothelial growth factor (VEGF). However, it is not only blood vessels that are responsible for tumor cell spread. During the process of tumor growth, lymphangiogenesis is mediated by other members of the VEGF family, specifically VEGF-C and VEGF-D, which act independent to bevacizumab. Therefore, based on the mechanism of bevacizumab action and the processes of angio- and lymphangiogenesis, we formed three hypotheses: (1) if the lymph nodes in primary ovarian cancers are metastatic, the outcome of bevacizumab treatment is worsened; (2) concerning the second-line treatment, bevacizumab will act in a weakened manner if recurrence occurs in lymph nodes as opposed to a local recurrence; (3) patients treated by bevacizumab are more likely to have recurrences in lymph nodes. These hypotheses raise the issue of the existing knowledge gap, which concerns the effect of bevacizumab on metastatic lymph nodes.
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Affiliation(s)
- Klaudia Żak
- Department of Medical Chemistry, Medical University of Lublin, 20-059 Lublin, Poland
| | - Małgorzata Satora
- I Chair and Department of Oncological Gynaecology and Gynaecology, Student Scientific Association, Medical University of Lublin, 20-059 Lublin, Poland
| | - Ilona Skrabalak
- I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Rafał Tarkowski
- I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Marta Ostrowska-Leśko
- Chair and Department of Toxicology, Medical University of Lublin, 20-090 Lublin, Poland
| | - Marcin Bobiński
- I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, 20-059 Lublin, Poland
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Shin DW, Bae J, Ha J, Jung KW. Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study. Front Oncol 2021; 11:639839. [PMID: 33996553 PMCID: PMC8113866 DOI: 10.3389/fonc.2021.639839] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/30/2021] [Indexed: 12/24/2022] Open
Abstract
Objective Conditional relative survival (CRS) rates, which take into account changes in prognosis over time, are useful estimates for survivors and their clinicians as they make medical and personal decisions. We aimed to present the 5-year relative conditional survival probabilities of patients diagnosed with ovarian cancer from 1997–2016. Methods This nationwide retrospective cohort study used data from the Korean Central Cancer Registry. Patients diagnosed with ovarian cancer between 1997 and 2016 were included. CRS rates were calculated stratified by age at diagnosis, cancer stage, histology, treatment received, year of diagnosis, and social deprivation index. Results The 5-year relative survival rate at the time of diagnosis was 61.1% for all cases. The probability of surviving an additional 5 years, conditioned on having already survived 1, 2, 3, 4, and 5 years after diagnosis was 65.0, 69.5, 74.6, 79.3, and 83.9%, respectively. Patients with poorer initial survival estimates (older, distant stage, serous histology) generally showed the largest increases in CRS over time. The probability of death was highest in the first year after diagnosis (11.8%), and the conditional probability of death in the 2nd, 3rd, 4th, and 5th years declined to 9.4%, 7.9%, 6.1%, and 5.2%, respectively. Conclusion CRS rates for patients with ovarian cancer increased with each year they survived, but this did not reach the level of ‘no excess mortality’ even 5 years after diagnosis. The largest improvements in CRS were observed in patients with poorer initial prognoses. Our findings provide updated prognosis to ovarian cancer survivors and clinicians.
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Affiliation(s)
- Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Jaeman Bae
- Department of Obstetric and Gynecology, Hanyang University, Seoul, South Korea
| | - Johyun Ha
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
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Carboni F, Federici O, Sperduti I, Zazza S, Sergi D, Corona F, Valle M. Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience. Cancers (Basel) 2021; 13:523. [PMID: 33572964 PMCID: PMC7866406 DOI: 10.3390/cancers13030523] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/24/2022] Open
Abstract
Despite improvement in treatments, the peritoneum remains the primary site of relapse in most ovarian cancer cases. Patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from epithelial ovarian cancer were reviewed. Kaplan-Meier curves and multivariate Cox analyses were used to identify survival rates and prognostic factors. This study included 158 patients. The procedure was mostly performed for recurrent disease (46.8%) and high-grade serous carcinoma (58.2%). The median peritoneal cancer index was 14, and complete cytoreduction was obtained in 87.9% of cases. Grade IV morbidity occurred in 15.2% of patients, mostly requiring surgical reoperation, and one patient (0.6%) died within 90 days. The median follow-up was 63.5 months. The Kaplan-Meier 5-year overall survival (OS) and disease-free survival (DFS) rates were 42.1% and 24.3%, respectively. Multiple regression logistic analyses demonstrated that the completeness of cytoreduction (CC) score (p ≤ 0.0001), pancreatic resection (p ≤ 0.0001) and number of resections (p = 0.001) were significant factors influencing OS; whereas the CC score (p ≤ 0.0001) and diaphragmatic procedures (p = 0.01) were significant for DFS. The addition of hyperthermic intraperitoneal chemotherapy to standard multimodality therapy may improve outcomes in both primary and recurrent epithelial ovarian cancer without impairing early postoperative results, but the exact timing has not yet been established. Prospective randomized studies will clarify the role and indications of this approach.
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Affiliation(s)
- Fabio Carboni
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (O.F.); (S.Z.); (F.C.); (M.V.)
| | - Orietta Federici
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (O.F.); (S.Z.); (F.C.); (M.V.)
| | - Isabella Sperduti
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Settimio Zazza
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (O.F.); (S.Z.); (F.C.); (M.V.)
| | - Domenico Sergi
- Department of Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Francesco Corona
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (O.F.); (S.Z.); (F.C.); (M.V.)
| | - Mario Valle
- Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (O.F.); (S.Z.); (F.C.); (M.V.)
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Primary site disease and recurrence location in ovarian cancer patients undergoing primary debulking surgery vs. interval debulking surgery. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2020; 47:1075-1082. [PMID: 32981794 DOI: 10.1016/j.ejso.2020.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/02/2020] [Accepted: 09/15/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The natural history and patterns of ovarian cancer (OC) relapse are still unclear. Recurrent disease can be peritoneal, parenchymal, or nodal. This study aims to analyze the location and pattern of OC recurrence according to the primary site of disease and to the type of surgical approach used. MATERIAL AND METHODS All OC patients underwent primary debulking surgery (PDS) or interval debulking surgery (IDS), with 2014 FIGO stage III-IV, and with platinum-sensitive recurrence were included in the study. Primary disease location and site of recurrences were divided into peritoneal, parenchymal, and nodal, according to the presence of peritoneal carcinomatosis, parenchymal metastasis, and nodal involvement, respectively. RESULTS A total of 355 patients were initially considered; of them, 295 met the inclusion criteria. Two hundred thirty-three patients obtained no macroscopic residual tumor at the end of primary surgical treatment. Primary parenchymal disease relapsed in 84.6% cases at a parenchymal site (p < 0.001), 97.2% of peritoneal diseases relapsed on the peritoneum (p < 0.001), and 100% of nodal diseases had a nodal recurrence (p < 0.001). Stratifying by the surgical approach all these correlations have been confirmed both in the PDS (p < 0.001) and IDS (p < 0.001) groups. CONCLUSION Our study shows that the site of relapse in cases of platinum-sensitive OC recurrence is closely related to the primary location of the disease, regardless of the type of initial treatment. Therefore, more attention during followup should be paid to areas where the initial tumor was present.
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Okunade KS, Adetuyi IE, Adenekan M, Ohazurike E, Anorlu RI. Risk predictors of early recurrence in women with epithelial ovarian cancer in Lagos, Nigeria. Pan Afr Med J 2020; 36:272. [PMID: 33088401 PMCID: PMC7546017 DOI: 10.11604/pamj.2020.36.272.17827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/25/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction epithelial ovarian cancer (EOC) is the most lethal gynaecological cancer with a recurrence rate as high as 85% after an initial treatment. However, there are currently no reliable means of predicting the risk of recurrence after first-line treatment. This study investigated the risk factors that predict early recurrence of EOC after primary treatment among women in Lagos, Nigeria. Methods this was a retrospective cohort study involving the review of all histologically confirmed EOC patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria over a 7-year period from January 2010 to December 2016. A study proforma was used to retrieve relevant information and descriptive statistics were computed for all data. The associations between variables were tested and multivariate analysis was done to adjust for all the possible characteristics that predict early EOC recurrence. Results the rate of recurrence of EOC was 76.4%. Suboptimal debulking surgery is the only independent predictor of early tumour recurrence. Conclusion women should be adequately counselled and encouraged to report their symptoms early to ensure optimal primary treatment. Strategic efforts should also be made to further improve subspecialty training programs and skills development in gynaecological oncology in Nigeria and sub-Saharan Africa.
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Affiliation(s)
- Kehinde Sharafadeen Okunade
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Imoleayo Elijah Adetuyi
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Muisi Adenekan
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ephraim Ohazurike
- Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Rose Ihuoma Anorlu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria
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Kanzaki R, Okami J, Takami K, Iwasaki T, Ikeda N, Funakoshi Y, Sakamaki Y, Kodama K, Yokouchi H, Kadota Y, Ose N, Shintani Y. Outcomes of surgical resection for pulmonary metastasis from ovarian cancer. J Cardiothorac Surg 2020; 15:182. [PMID: 32703262 PMCID: PMC7379766 DOI: 10.1186/s13019-020-01231-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/20/2020] [Indexed: 11/21/2022] Open
Abstract
Background Due to its rarity, information on pulmonary metastasectomy for pulmonary metastasis from ovarian cancer is limited. Methods Cases of pulmonary metastasectomy for ovarian cancer were collected in a multi-institutional setting and the outcomes were analyzed. Results Among 1508 cases in which pulmonary resection was performed to treat pulmonary metastasis from tumors of various organs, 6 cases (0.4%) involved pulmonary metastasis from ovarian cancer. The mean age was 61 years (range, 39–75 years). The histological types were undifferentiated carcinoma in 2 patients, and clear cell adenocarcinoma, serous papillary cystadenocarcinoma, serous adenocarcinoma, and endometroid adenocarcinoma in 1 patient each. One patient (17%) had a history of liver metastasis at the time of pulmonary resection. The median disease-free interval was 22 months (range, 0 [synchronous]-188 months). The tumor was solitary in 5 patients (83%). The mean tumor size was 15 mm (range, 5–23 mm). All 6 patients underwent complete resection. The type of resection was wide wedge resection in 3 patients, segmentectomy in 2 patients, and lobectomy in 1 patient. Four patients (67%) received postoperative chemotherapy. Thus far, 4 patients (67%) have experienced recurrence after pulmonary resection. In terms of outcomes, 1 patient who had synchronous pulmonary metastasis with the primary tumor died in the early period after pulmonary resection, 1 patient is alive without recurrence after a short follow-up period (5 months), 3 patients have achieved mid- to long-term survival and are alive with disease (38–61 months), and 1 patient achieved long-term (61 months) disease-free survival. Conclusions Patients with pulmonary metastasis from ovarian cancer who fulfill the eligibility criteria for pulmonary metastasectomy are rare. Pulmonary metastasectomy for ovarian cancer can provide favorable outcomes in highly selected patients. Patients with synchronous pulmonary metastasis from ovarian cancer are not good candidates for pulmonary metastasectomy.
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Affiliation(s)
- Ryu Kanzaki
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 (L5), Yamadaoka, Suita, 565-0871, Japan.
| | - Jiro Okami
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Takami
- Department of Thoracic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Teruo Iwasaki
- Department of General Thoracic Surgery, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - Naoki Ikeda
- Department of Thoracic Surgery, Sakai City Medical Center, Sakai, Japan
| | - Yasunobu Funakoshi
- Department of Thoracic Surgery, Osaka General Medical Center, Osaka, Japan
| | - Yasushi Sakamaki
- Department of Thoracic Surgery, Osaka Police Hospital, Osaka, Japan
| | - Ken Kodama
- Department of Thoracic Surgery, Yao Municipal Hospital, Yao, Japan
| | - Hideoki Yokouchi
- Department of Thoracic Surgery, Suita Municipal Hospital, Suita, Japan
| | - Yoshihisa Kadota
- Department of Thoracic Surgery, Osaka Habikino Medical Center, Habikino, Japan
| | - Naoko Ose
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 (L5), Yamadaoka, Suita, 565-0871, Japan
| | - Yasushi Shintani
- Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2 (L5), Yamadaoka, Suita, 565-0871, Japan
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Jennifer A, Iptissem N, Aurélie R, Philippe K, Marc AJ. The place of secondary complete cytoreductive surgery in advanced ovarian cancer. Horm Mol Biol Clin Investig 2019; 41:hmbci-2019-0030. [PMID: 31782948 DOI: 10.1515/hmbci-2019-0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/15/2019] [Indexed: 02/07/2023]
Abstract
Despite optimal treatment, three-quarters of the patients with advanced ovarian cancer, experiment relapse and its treatment has become a public health issue. Initially debated, surgery is gaining legitimacy in the treatment of late relapse patients, compared to chemotherapy alone. Secondary complete cytoreduction should be proposed only to a highly selected population. The type of surgery depends on the recurrence localization and the relapse extension in the pelvis and to other organs. Innovating techniques of surgery have become widespread including heated intra peritoneal chemotherapy (HIPEC), laparoscopy and robotic surgery. These specialized treatments should only be carried out in reference centers by oncological surgeons.
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Affiliation(s)
- Asmar Jennifer
- Department of Gynecology and Obstetrics, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
| | - Naoura Iptissem
- Department of Gynecology and Obstetrics, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
| | - Revaux Aurélie
- Department of Gynecology and Obstetrics, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
| | - Kadhel Philippe
- Department of Gynecology and Obstetrics, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France.,CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Pointe-à-Pitre, France
| | - Ayoubi Jean Marc
- Department of Gynecology and Obstetrics, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
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Rasmussen LA, Jensen H, Virgilsen LF, Falborg AZ, Møller H, Vedsted P. Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice. Eur J Cancer Care (Engl) 2019; 28:e13123. [PMID: 31231898 DOI: 10.1111/ecc.13123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/15/2019] [Accepted: 05/24/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Specialised follow-up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. METHODS This population-based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008-2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type. RESULTS Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%-6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37-0.61) for high educational level, 1.40 (1.16-1.68) for living alone and 2.38 (1.53-3.70) for high comorbidity. CONCLUSION The results may inform stratified risk assessment in decision of frequency, location and duration of post-cancer follow-up care.
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Affiliation(s)
- Linda Aagaard Rasmussen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Henry Jensen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Line Flytkjaer Virgilsen
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Alina Zalounina Falborg
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
| | - Henrik Møller
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Danish Clinical Registries (RKKP), Aarhus, Denmark
| | - Peter Vedsted
- Research Centre for Cancer Diagnosis in Primary Care, Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Wang YL, Peng HH, Su SY, Lin CT. Combined Immunotherapy (OK-432, IL-2) With Chemotherapy Decrease the Recurrence Rate in Advanced Ovarian Cancer. Reprod Sci 2018; 26:244-249. [PMID: 29658435 DOI: 10.1177/1933719118768684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE In advanced ovarian cancer, traditional therapy included debulking surgery and postoperative chemotherapy. We proposed immunochemotherapy (IMCT) combined with picibanil (OK-432), interleukin-2 (IL-2), and traditional platinum- and taxol-based chemotherapy as a better treatment option for advanced ovarian cancer. METHODS We retrospectively reviewed the medical records of 51 patients with advanced ovarian cancer between 2007 and 2015 at Chang Gung Memorial Hospital Linkou Medical Center, including 26 patients who were treated with OK-432, IL-2, and platinum- and taxol-based chemotherapy (IMCT group) after debulking surgery; another 25 were treated with traditional platinum- and taxol-based chemotherapy (traditional chemotherapy group) after debulking surgery. We analyzed the difference in age, follow-up period, recurrence rate, and diagnosis-to-recurrence period between the 2 groups. We also analyzed the difference in complete blood cell counts, differentiating counts, and cancer antigen 125 (CA-125) at 1 month after treatment. RESULTS The recurrence rate between the IMCT and traditional chemotherapy groups showed a significant difference (53.8% vs 88%; P = .0128). The diagnosis-to-recurrence duration was longer in the IMCT than in the traditional chemotherapy groups (33.21 vs 25.63 months), although no statistical significance was found ( P = .4668). In laboratory analysis at 1 month after treatment, the white blood cell, absolute neutrophil, and absolute lymphocyte counts (ALCs) were significantly higher in the IMCT group. On the other hand, CA-125 was significantly lower, and ALC was significantly higher in the nonrecurrence group. CONCLUSIONS Combined IMCT and chemotherapy have lower recurrence rate compared to traditional chemotherapy after debulking surgery for the treatment of advanced ovarian cancer.
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Affiliation(s)
- Yi-Lun Wang
- 1 Chang Gung University College of Medicine and Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Hsiu-Huei Peng
- 2 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan, Taiwan
| | - Sheng-Yuan Su
- 2 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan, Taiwan
| | - Cheng-Tao Lin
- 2 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan, Taiwan.,3 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan, Taiwan.,4 Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan, Taiwan
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