The efficacy of secondary cytoreductive surgery for recurrent ovarian, tubal, or peritoneal cancer in Tian-model low-risk patients.

• 宮本, 泰斗

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

• 濵西, 潤三

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

• 万代, 昌紀

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

• Abiko, Kaoru

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

• Hamanishi, Junzo

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

• Baba, Tsukasa

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine･Department of Obstetrics and Gynecology, Iwate Medical University Faculty of Medicine

• Mandai, Masaki

  Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine

抄録

Objective: In patients with recurrent ovarian cancer (ROC) in whom surgery is likely to render them disease-free, it is unclear whether secondary cytoreductive surgery (SCS) combined with chemotherapy is superior to chemotherapy alone. The aim of this study was to evaluate the 2 treatment options in Tian-model low-risk patients. Methods: We retrospectively reviewed 118 ROC cases treated in our hospital between 2004 and 2016. Of these, 52 platinum-sensitive cases were classified as low-risk (complete resection anticipated) using the Tian model. Prognostic factors were assessed with univariate and multivariate analysis using Cox's regression model. Progression-free survival (PFS) and overall survival (OS) were compared in patients treated with SCS plus chemotherapy (SCS group) and those treated with chemotherapy alone (chemotherapy group), using a propensity-score-based matching method. Results: By multivariate analysis, the only factor associated with better OS was SCS. PFS and OS were significantly longer in the SCS group compared to the chemotherapy group in the matched cohort (median PFS: 21.7 vs. 15.1 months, p=0.027 and median OS: 91.4 vs. 33.4 months, p=0.008, respectively). In cases with multiple-site recurrence, the SCS group also showed significantly longer OS than the chemotherapy group (median 91.4 vs. 34.8 months, p=0.022). In almost all SCS cases, cooperation was required from other departments, and operation time was lengthy (median 323 minutes); however, no serious complications occurred. Conclusion: SCS combined with chemotherapy results in better PFS and OS than chemotherapy alone in first platinum-sensitive ROC patients categorized as low-risk by Tian's model.

収録刊行物

• Journal of gynecologic oncology

  Journal of gynecologic oncology 30 (6), 2019-11

  Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology and Colposcopy

キーワード

• Carcinoma
• Ovarian Epithelial
• Recurrence
• Cytoreduction Surgical Procedures
• Chemotherapy
• Tian Model

詳細情報

• CRID: 1050004953498544384
• NII論文ID: 120006894002
• ISSN: 20050380
• HANDLE: 2433/255636
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles