2
|
Vergote I, Denys H, De Greve J, Gennigens C, Van De Vijver K, Kerger J, Vuylsteke P, Baurain JF. Treatment algorithm in patients with ovarian cancer. Facts Views Vis Obgyn 2020; 12:227-239. [PMID: 33123697 PMCID: PMC7580261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Most ovarian cancer patients are diagnosed only at advanced stages when survival outcomes are worse, andwhen therapeutic decisions might prove challenging. The fundamental treatment for women with ovarian cancerincludes debulking surgery whenever possible and appropriate systemic therapy (chemotherapy, targeted andantiangiogenic agents). In the last few years, knowledge about histological and molecular characteristics of ovariancancer subtypes and stages has increased considerably. This has enabled the development and improvement ofseveral options for the diagnosis and treatment of ovarian cancer in a patient-tailored approach. Accordingly,therapeutic decisions are guided by the characteristics of the patient and the tumour, especially the molecularfeatures of the cancer subtype and disease stage. Particularly relevant are the advances in early genetic testing ofgermline and somatic mutations involved in DNA repair, and the clinical development of targeted agents. In orderto implement the best individual medical strategies, in this article, we present an algorithm of treatment options,including recently developed targeted agents, for primary and recurrent ovarian cancer patients in Belgium.
Collapse
Affiliation(s)
- I Vergote
- Department of Oncology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - H Denys
- Department of Medical Oncology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - J De Greve
- Department of Medical Genetics, University Hospitals Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - C Gennigens
- Department of Medical Oncology, Liège University Hospital, Avenue de l'Hôpital 1, 4000 Liège, Belgium
| | - K Van De Vijver
- Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
- Department of Pathological Anatomy, Antwerp University Hospital, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - J Kerger
- Jules Bordet Institute, Brussels University Hospital,Boulevard de Waterloo 121, 1000 Brussels, Belgium
| | - P Vuylsteke
- Department of Oncology, UCLouvain, CHU UCL Namur Hospital, Site St-Elisabeth, Place Louise Godin 15, 5000 Namur, Belgium
| | - J F Baurain
- Department of Oncology, UCLouvain, CHU UCL Namur Hospital, Site St-Elisabeth, Place Louise Godin 15, 5000 Namur, Belgium
- Department of Oncology, St.-Luc University Hospital Brussels, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Belgium
| |
Collapse
|
3
|
Hirakawa T, Minaguchi T, Itani Y, Kasamatsu Y, Murase S, Sakurada S, Nagano H, Takehara K, Tsuruta T, Arakawa A, Kawano K, Tsubamoto H, Ushiwaka T, Mori T, Iwai K, Saito M, Morisawa H, Saito F, Yoshida K, Kaneuchi M, Sato H, Ito K, Nasu K. Current status of tertiary debulking surgery and prognosis after secondary debulking surgery for recurrent Müllerian epithelial cancer in Japan: a retrospective analysis of 164 patients (KCOG-G1402). World J Surg Oncol 2017; 15:132. [PMID: 28716033 PMCID: PMC5512837 DOI: 10.1186/s12957-017-1200-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 07/03/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to evaluate the current status of secondary debulking surgery (SDS) and tertiary debulking surgery (TDS; performed for recurrence after SDS) and to assess the overall survival after recurrence of Müllerian epithelial cancer in Japan. We also evaluated the data of patients who underwent a fourth debulking surgery (i.e., quaternary debulking surgery (QDS)). Methods We conducted a retrospective study of 164 patients with recurrent Müllerian epithelial cancers (i.e., ovarian, tubal, and peritoneal cancers). The SDS was performed between January 2000 and September 2014 in 20 Japanese hospitals. Clinicopathological data were collected and analyzed. Results Of the 164 patients, 66 patients did not have a recurrence or died after SDS. Ninety-eight patients had a recurrence after SDS. Forty-three of the 98 patients underwent TDS; 55 of the 98 patients did not undergo TDS and were classified into the non-TDS group. The overall survival (OS) after SDS was significantly better in the TDS group than in the non-TDS group. The median OS after SDS was 123 and 42 months in the TDS group and non-TDS group, respectively. Of the 43 patients who received TDS, 11 patients were further treated with QDS. The median OS after SDS was 123 months for patients who underwent QDS. Conclusions This multicenter study on the prognosis of post-SDS is apparently the first report on QDS in Japan. Patients undergoing TDS have a good prognosis, compared to patients in the non-TDS group. Novel drugs are being evaluated; however, debulking surgery remains a necessary treatment for recurrence.
Collapse
Affiliation(s)
- Tomoko Hirakawa
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan. .,Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan.
| | - Takeo Minaguchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8576, Japan
| | - Yoshio Itani
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Nara Prefecture General Medical Center, Nara, 631-0846, Japan
| | - Yuka Kasamatsu
- Division of Gynecology, Shizuoka Cancer Center Hospital, Suntou, Shizuoka, 411-8777, Japan
| | - Saki Murase
- Department of Obstetrics and Gynecology, Gifu University, Gifu, 501-1194, Japan
| | - Shoko Sakurada
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi, 980-8574, Japan
| | - Hiroaki Nagano
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Tokyo Women׳s Medical University Medical Center East, Arakawa, Tokyo, 116-8567, Japan
| | - Kazuhiro Takehara
- Department of Gynecologic Oncology, Shikoku Cancer Center, Matsuyama, Ehime, 791-0280, Japan
| | - Tomohiko Tsuruta
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Hyogo, 660-8511, Japan
| | - Atsushi Arakawa
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, 467-8602, Japan
| | - Kouichiro Kawano
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroshi Tsubamoto
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan
| | - Takashi Ushiwaka
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Kochi Medical School, Nankoku, Kochi, 783-8505, Japan
| | - Taisuke Mori
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Kana Iwai
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, 634-8521, Japan
| | - Motoaki Saito
- Department of Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, 105-8471, Japan
| | - Hiroyuki Morisawa
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan
| | - Fumitaka Saito
- Department of Obstetrics and Gynecology, Faculty of Life Science, Kumamoto University, Kumamoto, 860-8556, Japan
| | - Kenta Yoshida
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Mie University School of Medicine, Tsu, Mie, 514-8507, Japan
| | - Masanori Kaneuchi
- Department of Obstetrics and Gynecology, Nagasaki University, Nagasaki, 852-8501, Japan
| | - Hiroki Sato
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| | - Kimihiko Ito
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Amagasaki, Hyogo, 660-8511, Japan
| | - Kaei Nasu
- Kansai Clinical Oncology Group (KCOG), 5-30 Tennoji, Osaka, 543-8555, Japan.,Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu-shi, Oita, 879-5593, Japan
| |
Collapse
|