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The current role of secondary cytoreductive surgery for recurrent ovarian cancer
Ovarian cancer represents worldwide the second most frequent and the most fatal gynecological malignancy, with approximately two thirds of the patients presenting with advanced disease. Cytoreductive surgery, primary or after neoadjuvant chemotherapy, in combination with platinum-based chemotherapy...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633943/ https://www.ncbi.nlm.nih.gov/pubmed/36338689 http://dx.doi.org/10.3389/fonc.2022.1029976 |
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author | de Bree, Eelco Michelakis, Dimosthenis Anagnostopoulou, Elisavet |
author_facet | de Bree, Eelco Michelakis, Dimosthenis Anagnostopoulou, Elisavet |
author_sort | de Bree, Eelco |
collection | PubMed |
description | Ovarian cancer represents worldwide the second most frequent and the most fatal gynecological malignancy, with approximately two thirds of the patients presenting with advanced disease. Cytoreductive surgery, primary or after neoadjuvant chemotherapy, in combination with platinum-based chemotherapy is the standard of care for these patients. Despite the improvement in quality of cytoreductive surgery as well as development of novel drugs and chemotherapy regimens, still most women with ovarian cancer will ultimately develop recurrent disease and die of their disease. In contrast to the management of primary disease, the standard treatment of patients with recurrent ovarian cancer remains a topic of debate. While platinum-based or second line systemic chemotherapy, depending on the time after last platinum treatment, is standard of care, the role of secondary cytoreductive surgery has been a controversial issue for the last decades. Potential outcome benefit must be also weighed against the risk of severe surgical morbidity, impairment of quality of life and costs. In platinum-resistant recurrent disease, i.e., relapse after less than 6 months from the last platinum-based chemotherapy for primary disease, secondary cytoreduction seems generally not to be indicated due to its aggressive biological behavior and the absence of effective systemic treatment. In this comprehensive review, the current role of cytoreductive surgery in platinum-sensitive recurrent ovarian cancer is discussed thoroughly in view of the results of most recent randomized trials and a meta-analysis. There seems to be definitely a role for secondary cytoreductive surgery in selected patients with ovarian cancer recurrence in whom complete resection of macroscopic disease is feasible. However, its role should be continuously reviewed due to the changing systemic treatment of patients with ovarian cancer recurrence over time. |
format | Online Article Text |
id | pubmed-9633943 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96339432022-11-05 The current role of secondary cytoreductive surgery for recurrent ovarian cancer de Bree, Eelco Michelakis, Dimosthenis Anagnostopoulou, Elisavet Front Oncol Oncology Ovarian cancer represents worldwide the second most frequent and the most fatal gynecological malignancy, with approximately two thirds of the patients presenting with advanced disease. Cytoreductive surgery, primary or after neoadjuvant chemotherapy, in combination with platinum-based chemotherapy is the standard of care for these patients. Despite the improvement in quality of cytoreductive surgery as well as development of novel drugs and chemotherapy regimens, still most women with ovarian cancer will ultimately develop recurrent disease and die of their disease. In contrast to the management of primary disease, the standard treatment of patients with recurrent ovarian cancer remains a topic of debate. While platinum-based or second line systemic chemotherapy, depending on the time after last platinum treatment, is standard of care, the role of secondary cytoreductive surgery has been a controversial issue for the last decades. Potential outcome benefit must be also weighed against the risk of severe surgical morbidity, impairment of quality of life and costs. In platinum-resistant recurrent disease, i.e., relapse after less than 6 months from the last platinum-based chemotherapy for primary disease, secondary cytoreduction seems generally not to be indicated due to its aggressive biological behavior and the absence of effective systemic treatment. In this comprehensive review, the current role of cytoreductive surgery in platinum-sensitive recurrent ovarian cancer is discussed thoroughly in view of the results of most recent randomized trials and a meta-analysis. There seems to be definitely a role for secondary cytoreductive surgery in selected patients with ovarian cancer recurrence in whom complete resection of macroscopic disease is feasible. However, its role should be continuously reviewed due to the changing systemic treatment of patients with ovarian cancer recurrence over time. Frontiers Media S.A. 2022-10-21 /pmc/articles/PMC9633943/ /pubmed/36338689 http://dx.doi.org/10.3389/fonc.2022.1029976 Text en Copyright © 2022 de Bree, Michelakis and Anagnostopoulou https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology de Bree, Eelco Michelakis, Dimosthenis Anagnostopoulou, Elisavet The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title | The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title_full | The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title_fullStr | The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title_full_unstemmed | The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title_short | The current role of secondary cytoreductive surgery for recurrent ovarian cancer |
title_sort | current role of secondary cytoreductive surgery for recurrent ovarian cancer |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633943/ https://www.ncbi.nlm.nih.gov/pubmed/36338689 http://dx.doi.org/10.3389/fonc.2022.1029976 |
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