National Cancer Institute®
Last Modified: February 1, 2002
UI - 11778564
AU - Li X; Liu L; Wu L
TI - [Ifosfamide combination chemotherapy for advanced gynecologic malignancies]
SO - Zhonghua Zhong Liu Za Zhi 2000 Jul;22(4):330-2
AD - Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.
OBJECTIVE: To evaluate the clinical efficacy and toxicity of ifosfamide (IFO) combination chemotherapy in patients with advanced gynecologic malignancies. METHODS: Thirty-four patients with gynecologic malignancies were included in this series. Of the 34 patients, 26 with epithelial cancer of the ovary were previously treated with cisplatin-containing combination chemotherapy but failed to respond or recurred after treatment. They were treated with IEP (IFO, VP16, PDD) regimen. The remaining 8 patients with uterine sarcoma (5 cases), squamous-cell carcinoma of the uterine cervix with metastases to the liver or bone (2 cases), and endometrial carcinoma with lung metastases (1 case) were treated with IFO combination chemotherapy. At least two courses of treatment were given unless tumor progression occurred after the first course. RESULTS: The overall response rate was 35.3% including 8.8% complete response. The response rate of 26 patients with ovarian cancer was 30.8%. Two patients with PDD-sensitive tumor all achieved complete response, which lasted for one year. The response rate of the remaining 24 PDD-resistant patients was 25% with a mean duration of 5.5 months. There was no complete response. Two patients with cervical carcinoma and two of five patients with uterine sarcoma responded to IFO combination chemotherapy. Relatively severe hematological toxicity was observed, including grade III and IV leucopoenia and thrombocytopenia. Two patients died from severe toxicity. CONCLUSION: IFO combination chemotherapy is effective in treating recurrent or progressive gynecologic malignancies, especially PDD-sensitive ones. Myelosuppression is relatively severe which may be due to prior long term and intensive chemotherapy.
UI - 11521789
AU - Boccardo F; Miglietta L; Bruzzone M; Rubagotti A; Locatelli MC; Ragni N
TI - Paclitaxel plus organoplatins: still the gold standard in advanced ovarian cancer?
SO - Ann Oncol 2001 Jul;12(7):1023-4
UI - 11769669
AU - Zhang A; Lu Y; Wang S
TI - [Relationship between the expression of connexin 43 and bystander effect of suicide gene therapy in ovarian cancer]
SO - Zhonghua Fu Chan Ke Za Zhi 2001 Sep;36(9):542-5
AD - Department of Obstetrics and Gynecologic, Tongji Hospital, Tongji Medical College, Huazhong Science and Technology University, Wuhan 430030, China.
OBJECTIVE: To explore the relationship of connexin 43(Cx43) and bystander effect in ovarian tumor cells in herpes simplex virus thymidine kinase/ganciclovir (HSV-TK/GCV) gene therapy in vitro, and to investigate the effection of all-trans retinoic acid (RA) on expression of Cx43 and bystander effect. METHODS: Cx43 expression was examined with flowcyto-metry, Western Blot, and immunofluorescence in two ovarian tumor cells OVCAR3, CAOV3 before and after RA treatment. Bystander effect was determined by the cells growth inhibitory rate with methyl thiazolyl tetrazolium. RESULTS: Following exposure to ganciclovir, there was much greater bystander killing in OVCAR3 than in CAOV3 (P < 0.05). The expression of Cx43 was detected in OVCAR3 with flowcytometry and Wstern Blot, but it could not be detected in CAOV3. The expression of Cx43 in both cell lines could be induced by RA. Immunofluorescence staining showed that OVCAR3 Cx43 protein is located in membrane surface, whereas CAOV3 is in cytoplasm. RA could not change the location of Cx43 protein in both cell lines. CONCLUSIONS: There is relationship between Cx43 expression and HSV-TK/GCV bystander effect. HSV-TK/GCV bystander effect can be inhanced by RA in ovarian cancer.
UI - 11526698
AU - Zanetta G; Meni A; Brancatelli G; Chiari S; Lissoni AA; Ratti M; Buda A
TI - [Comparison of methods for monitoring young women with stage I borderline ovarian tumor after conservative surgery]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):10-1
AD - Istituto di Scienze Biomediche S. Gerardo Clinica Ostetrica e Ginecologica, Universita degli Studi Bicocca, Milano.
UI - 11526699
AU - Balbi GC; Compagna R; Musone R; Cirelli G; Delli Ponti D; Cassese E;
TI - Passaro M; Balbi F; Zarcone R [Role of intestinal resection in primary cytoreduction of ovarian cancer]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):100-1
AD - Istituto di Clinica Ostetrica e Ginecologica, Seconda Universita degli Studi, Napoli.
BACKGROUND: The aim of this study is to define the role of the intestinal removal for the therapy of ovarian cancer in advanced stadium. METHODS: We have examined 247 females with epithelial ovarian cancer in advanced stadium, that had intestinal removal. RESULTS: The survival in the females that had a very good intestinal removal is greatest than in the females that hadn't a very good intestinal removal.
UI - 11526701
AU - Balbi GC; Compagna R; Musone R; Cirelli G; Sgambato R; Cassese E; Delli
TI - Ponti D; Passaro M; Zarcone R [Cytoreductive surgery in patients with stage IV ovarian carcinoma]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):105-9
AD - Istituto di Clinica Ostetrica e Ginecologica, Seconda Universita degli Studi, Napoli.
BACKGROUND: The aim of this study is to evaluate the efficacy of cytoriductive surgical in females with ovarian carcinoma in advanced stadium, and to define the role of this surgical for the survival of females with hepatic metastases. METHODS: This is a retrospective study. 164 females with ovarian cancer in IV stadium was examined. 64 females had hepatic metastasis. All patients had cytoriductive surgical. RESULTS: The survival in the patients without hepatic metastasis was 38 months if the cytoreduction was very good; it was 18.3 months if there is residual disease. The survival in the patients with hepatic metastasis was 50.1 months if the cytoreduction was very good; it was 27 months if there is residual disease. CONCLUSIONS: A very good surgical is very important for the survival of patients with ovarian cancer in advanced stadium. This is true also in the patients with hepatic metastases.
UI - 11526704
AU - Rampone B; Rampone A; Tirabasso S; Panariello S; Rampone N
TI - Immunological variations in women suffering from ovarian cancer. Influence of radical surgical treatment.
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):116-9
AD - Institute of Obstetrics and Gynaecology, Second University of Naples, Italy.
BACKGROUND: The immune system includes all the innate or acquired mechanisms, that the organism uses for protecting itself from the aggression of external pathogens or neoplasia. About the control of the tumor growth, the immune mechanisms implicated are quite a lot: the cytotoxicity against the tumor cells by cytotoxic T lymphocyte, macrophages, NK cells; simil-NK cells (ADCC). Tumors have generally antigenic marked potential, for which numerous antigens have been identified, but none of these has revealed a correlated specificity to the neoplasia. Only a glycoprotein at elevated molecular weight, the CA125, presents an elevated specificity and sensibility. The objective of this study was to examine immunological variations in the peripheral blood of patients with ovarian carcinoma before and after radical surgical treatment. METHODS: In the Institute of Obstetrics and Gynaecology of Second University of Studies of Naples the immunological variations in 8 women (mean age: 59.5; range: 49-70 years) suffering from ovarian cancer, have been evaluated before and after radical surgical treatment (when the stage of the tumor made possible the surgery) and compared to 8 normal volunteers of comparable age (control in average for two years and subjected to a immunological screening with blood drawings effected at the hospitalisation and later 1, 6, 12, 18, 24 months from surgical treatment. The immune evaluation were effected with: proliferation tests on the monocytes of the peripheral blood, evaluation of the production of Interleukin 1 and 2 with the leukocyte phenotyping, evaluation of NK cells activity. The patients were followed in average for two years. RESULTS: The radical surgery decidedly improves the immune response. The ability to produce IL-1 by the lymphocytes of the patients object of our study, appeared constantly falling (with reduction of about 50%) before the surgery and it meaningfully increases in the post-surgery period. The surgery doesn't modify the lymphocytes T helper and T inducer. The surgery delays the diminution of the NK cells in a little meaningful way. The periodic dosage of the CA125 does not give the same results: in the 60% a progressive increase was realised and in the 40% it remained constant. CONCLUSIONS: The surgery constantly improved the physical state of the patient, determining an increase of the immune response toward the neoplasia, and therefore achieving a meaningful increase of survival.
UI - 11526711
AU - Russo A; Cirelli G; Cassese E; Delli Ponti D; Sgambato R; Cecere F;
TI - Zarcone R [Second-look in ovarian cancer: laparoscopy or laparotomy?]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):146-54
AD - Istituto di Ginecologia ed Ostetricia, Seconda Universita degli Studi di Napoli. Alef2@wappi.com
BACKGROUND: The aim of the present study was to compare the laparoscopic second-look with laparotomic second-look as regards the consistency of diagnosis of residual tumoral disease after first step treatment in patients affected by ovarian cancer, and to evaluate the feasibility of the laparoscopic second-look. METHODS: Twenty-one patients affected by ovarian cancer underwent laparoscopic second-look followed by laparotomic second-look. Six months after the first surgical intervention all the patients showed no contraindications to laparoscopic second-look. All the surgeries were performed with the same procedure: after the introduction of the trocars the lysis of adherences was carried out, the whole abdominal cavity was explored, 18 abdominal-pelvic sites were examined, direct biopsies were performed and samples for the cyto- and histological analysis were obtained. RESULTS: Positive predictive value for laparoscopy was 100% (6 out of 6 cases), while negative predictive value was 84% (2 false negative cases out of 12). The complete abdominal-pelvic examination was possible in 95% of cases with laparotomy while in 41% of cases with laparoscopy, because of post-operative severe adherences. CONCLUSIONS: Laparoscopic second-look has a good consistency as regards the diagnosis of residual tumoral disease, but its feasibility is lower than laparotomy owing to the presence of severe adherences and the high risk of intra- and post-operative compliances.
UI - 11526713
AU - Scarabelli C; Gallo A
TI - [Second surgery of ovarian carcinoma]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):25-8
AD - Divisione di Oncologia Chirurgica Ginecologica, Centro di Riferimento Oncologico di Aviano, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico, Aviano, Pordenone.
UI - 11526714
AU - Cortesi E; Martelli O; Padovani A
TI - [Role of intraperitoneal chemotherapy]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):29-33
AD - Dipartimento di Medicina Sperimentale e Patologia, Universita degli Studi di Roma La Sapienza, Roma.
UI - 11526718
AU - Ferrandina G; Legge F; Fagotti A; Fanfani F; Mancuso S; Scambia G
TI - [Biological factors with prognostic significance in ovarian cancer]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):40-5
AD - Istituto di Clinica Ostetrica e Ginecologica, Universita Cattolica del Sacro Cuore, Roma.
UI - 11526723
AU - Bolis PF; Zanaboni F; Crotti S
TI - [Borderline ovarian tumors]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):6-9
AD - Clinica Ostetrica e Ginecologica, Universita dell'Insubria, Sede vi Varese.
UI - 11526725
AU - Ambrosio D; Piscopo L; Lauro C; Rotondi M; Gallo E; Balbi F
TI - [Treatment of ovarian carcinoma with intraperitoneal administration of interferon alpha 2b]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):67-71
AD - I Divisione Clinica Ostetrica e Ginecologica, Seconda Universita degli Studi, Napoli.
BACKGROUND: Pharmacokinetic studies have confirmed that for many chemotherapeutic agents a substantial pharmacological advantage can be achieved using the intraperitoneal route. Aim of this study is to evaluate the efficacy of intraperitoneal interferon alpha 2b chemotherapy to treat ovarian cancer. METHODS: Forty-four patients affected by ovarian cancer have been submitted to intraperitoneal Gynecology and Obstetric Institute of the Second University of Naples. Intraperitoneal route has been obtained through a catheter in left iliac fossa. Drugs have been solved in 2000 ml of physiologic solution to obtain a better distribution into the peritoneal fluid. RESULTS: Three patients of 15 not-pre-medicated and 16 of 24 pre-medicated have obtained complete anatomo-pathological resolution. No compliances have been checked about catheter. Only two patients have stopped the therapy for asthenia; all the others have well tolerated interferon. CONCLUSIONS: Our study shows the very low toxicity of interferon associated to a good tolerance of the intraperitoneal catheter and therefore we retain that intraperitoneal chemotherapy with interferon alpha 2b improves the prognosis of patients with minimal ovarian cancer after systemical chemotherapy.
UI - 11526732
AU - Iervolino P; Palmieri M; Rotondi M; D'Alessandro P; Iuliano R
TI - [Borderline ovarian tumors. Retrospective analysis of 20 cases]
SO - Minerva Ginecol 2001 Feb;53(1 Suppl 1):97-9
AD - Divisione di Ostetricia e Ginecologia, Ospedale S. Maria di Loreto Nuovo, Napoli.
BACKGROUND: To evaluate the clinical features, the surgical management and outcome of 20 patients with stage-I borderline ovarian tumors. METHODS: Twenty cases of FIGO stage-I ovarian tumors, aged from 31 to 58 years (mean 37 years) have been reviewed. All informations of clinical stage, surgical intervention and prognosis were achieved by reviewing hospital records. Minimal requirements for conservative management were adequate staging and complete information about the therapeutic options. Factors important in the choice of the treatment were, age, wish to preserve fertility, histologic type and grade, and the stage of the tumour. RESULTS: Eleven of the 20 patients (55%) were at stage IA, 6 cases (30%) were at stage IB, 3 cases (15%) were at stage IC. Thirteen (65%) were with mucinous cystadenoma of borderline malignancy, 7 cases (35%) were of serous type. Thirteen patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO). Seven patients were treated with unilateral oophorectomy or unilateral salpingo-oophorectomy (USO). One patient underwent enucleation of ovarian tumor and biopsy of contralateral ovary. Any patient were treated with chemotherapy after operation. With a median follow up of two years, we observed no recurrence of carcinoma in women treated conservatively or in those treated more radically. CONCLUSIONS: Conservative surgery remains a therapeutic option in selected patients with borderline ovarian tumors. Prolonged intensive follow-up is required for women treated conservatively for borderline malignant ovarian tumours.
UI - 11799032
AU - Kirwan JM; Tincello DG; Herod JJ; Frost O; Kingston RE
TI - Effect of delays in primary care referral on survival of women with epithelial ovarian cancer: retrospective audit.
SO - BMJ 2002 Jan 19;324(7330):148-51
AD - Liverpool Women's Hospital. firstname.lastname@example.org
OBJECTIVE: To examine referral pathways from primary care for patients with epithelial ovarian cancer and to identify factors related to survival at 18 months. DESIGN: Retrospective review of patient notes. SETTING: General practices and receiving hospitals within Mersey region. SUBJECTS: 135 patients with epithelial ovarian cancer identified from an audit in the Mersey area between 1992 and 1994. MAIN OUTCOME MEASURES: Delays between onset of symptoms and treatment attributable to patient, general practitioner, and hospital. RESULTS: 105 (78%) women first presented to their general practitioner within four weeks of the onset of symptoms. 99 (73%) women were referred to hospital by their general practitioners within four weeks of presentation, and 95 (70%) were seen in hospital within two weeks of referral. Multivariate analysis with survival as the dependent variable identified age (odds ratio 0.96, 95% confidence interval 0.93 to 0.99) cancer stage III or more (0.15, 0.05 to 0.43), and non-specific symptoms (0.36, 0.14 to 0.89) as significant variables. CONCLUSION: Most patients attended their general practitioner within four weeks and were referred within two weeks. No evidence was found that delays in referral or diagnosis adversely affected survival at 18 months. Stage of disease at surgery was the most important adverse factor. An effective screening programme is the most likely method to improve survival.
UI - 11586410
AU - Kolesnikova AI; Sychenkova NI; Konoplyannikov AG; Lepekhina LA; Kal'sina
TI - SS; Krikunova LI; Mardynskii YS Effect of irradiation on colony-forming ability of stem cells from patients with ovarian cancer.
SO - Bull Exp Biol Med 2001 Jun;131(6):570-2
AD - Medical Research Center for Radiology, Russian Academy of Medical Sciences, Obninsk.
In patients with ovarian cancer, the colony-forming capacity and radiosensitivity of clonogenic tumor cells from the primary node and metastases (ascites) differed considerably.
UI - 11790279
AU - Snow PB; Brandt JM; Williams RL
TI - Neural network analysis of the prediction of cancer recurrence following debulking laparotomy and chemotherapy in stages III and IV ovarian cancer.
SO - Mol Urol 2001 Winter;5(4):171-4
AD - Xaim, Inc., Colorado Springs, Colorado 80918, USA. email@example.com
An artificial neural network (ANN) has been developed to predict the presence or absence of cancer following debulking laparotomy and chemotherapy in patients with stages III and IV ovarian cancer. The presence or absence of a residual gross tumor or microscopic disease was determined by a second-look laparotomy. The ANN was trained and tested using detailed operative findings and related surgical procedures associated with the debulking surgery. The ANN predictive results were compared with linear and logistic regression. The ANN significantly outperformed both logistic and linear regression analyses, but additional cases are needed to validate the network.
UI - 11825920
AU - McCluggage WG; Lyness RW; Atkinson RJ; Dobbs SP; Harley I; McClelland
TI - HR; Price JH Morphological effects of chemotherapy on ovarian carcinoma.
SO - J Clin Pathol 2002 Jan;55(1):27-31
AD - Department of Pathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BL, Northern Ireland. firstname.lastname@example.org
AIMS: Traditionally, advanced stage ovarian carcinoma is treated by debulking surgery followed by chemotherapy. However, in some circumstances preoperative chemotherapy may be given before optimal surgical debulking. This study aims to describe the morphological features found in ovarian carcinoma after chemotherapy because these have not been detailed previously. METHODS: Histological sections were examined from 18 cases of ovarian carcinoma that had been treated by preoperative chemotherapy. The morphology was compared with any pre-chemotherapy biopsies that had been performed. Tumours were classified as showing morphological features suggesting a good response to chemotherapy (n = 14) or as showing little or no response (n = 4). Serum CA125 values before and after chemotherapy were compared. In all cases, the mitotic activity index (MAI), volume percentage of epithelium (VPE), and mean nuclear area (MNA) of tumour cells were calculated. RESULTS: The preoperative biopsies were all typical ovarian serous or endometrioid adenocarcinomas. Morphological features present in the group responding to chemotherapy included the presence of small groups or single tumour cells in a densely fibrotic stroma. Tumour cells were characterised by both nuclear and cytoplasmic alteration, making accurate tumour typing and grading impossible. Nuclear features included the presence of bizarre enlargement with hyperchromatism, irregularity of outline, and chromatin clumping or smudging. Cytoplasmic alterations included intense eosinophilia, vacuolation, or foam cell change. There were pronounced stromal changes of fibrosis, inflammation, collections of foamy histiocytes, cholesterol cleft formation, haemosiderin deposition, fat necrosis, and dystrophic calcification, including the presence of many free psammoma bodies. There was no correlation between morphological response and biochemical response, as determined by serum CA125 values. In all nine cases in which pre-chemotherapy and post-chemotherapy biopsies were available, the MNA increased post-chemotherapy (p = 0.007, paired Wilcoxon test) and in six of nine cases the MAI decreased (p = 0.093). CONCLUSIONS: Because preoperative chemotherapy is being used increasingly in the management of ovarian cancer, pathologists should be aware of the resultant morphological effects. Accurate tumour typing and grading is impossible. In some cases, it may be difficult to confirm the presence of residual tumour, making it imperative that pre-chemotherapy tissue biopsies are obtained. Definite confirmation of residual tumour may require the examination of multiple histological sections from areas showing pronounced stromal changes, sometimes with multiple levels and immunohistochemistry. In the absence of definite residual tumour, the report should state that the features are consistent with the prior presence of tumour.
UI - 11833305
AU - Hamid D; Rohr S; Baldauf JJ; Ritter J; Kurtz E; Dufour P; Meyer P;
TI - Minetti A; Meyer C [Interest in intestinal resection for treatment of advanced ovarian cancer]
SO - Ann Chir 2002 Jan;127(1):40-7
AD - Service de gynecologie-obstetrique I, hopitaux universitaires de Strasbourg-Hautepierre, 1, avenue Moliere, 67200 Strasbourg, France.
AIM OF THE STUDY: Digestive surgery is often necessary for surgical management of advanced ovarian carcinoma. PATIENTS AND METHODS: In a series of 62 patients with stage III ovarian carcinoma, postoperative morbidity and mortality, overall survival after 5 years and disease-free survival after 2 years were studied and corelated with several patients criteria (age, stage of the disease, residual disease, type of surgery, CA125 normalisation delay, postoperative complications and hospital stay). Patients were divided into two groups according to the surgical treatment. The first group (n = 17) included patients treated by gynecologic and digestive surgery, the second group (n = 45) included patients treated by gynecologic surgery only. All patients were proposed for chemotherapy included platyn salt. Mean age was 60 years (range: 20-83). The stage of the cancer was stage IIIa in 7 cases, stage IIIb in ten and stage IIIc in 45. RESULTS: Postoperative mortality was 3.5% (2/62). Postoperative morbidity was 26% (13/62). No statistical differences were noted for hospital stay, general morbidity, surgical morbidity when a gastric resection or a colon resections or a splenectomy were performed. Overall survival at 5 years was 56%. Residual disease less than 2 cm3 is the only prognostic factor for overall survival (56% vs 23% [P = 0.03]) and disease-free survival (86% vs 46% [P = 0.02]). CONCLUSION: This study including 62 patients confirmed the prognostic significance of extensive cytoreductive surgery for treatment in advanced ovarian epithelial cancer without increasing the postoperative morbidy and mortality.
UI - 11583193
AU - du Bois A; Luck HJ; Pfisterer J; Schroeder W; Blohmer JU; Kimmig R;
TI - Moebus V; Quaas J Second-line carboplatin and gemcitabine in platinum sensitive ovarian cancer--a dose-finding study by the Arbeitsgemeinschaft Gynakologische Onkologie (AGO) Ovarian Cancer Study Group.
SO - Ann Oncol 2001 Aug;12(8):1115-20
AD - Department of Gynecology, Dr.-Horst-Schmidt-Kliniken Wiesbaden, Germany. email@example.com
BACKGROUND: Despite the progress that has been achieved in the last years, recurrence rates in ovarian cancer patients are still considerably high and the majority of patients ultimately become candidates for second-line treatment. Carboplatin reinduction is a broadly adopted regimen in patients with recurrences occurring six months or later after first-line treatment. Gemcitabine is among the candidates as combination partner in second-line regimens. PATIENTS AND METHODS: We performed a study with escalating doses of gemcitabine combined with carboplatin in 26 platinum-pretreated patients with recurrent ovarian cancer and a treatment-free interval of 6+ months. Dose-limiting toxicity (DLT) and a maximum tolerable dose (MTD) recommendable for further trials was evaluated. RESULTS: The DLT was myelosuppression, mainly thrombocytopenia. No dose limiting non-hematological toxicities were observed. The MTD of gemcitabine was 1,000 mg/m2 given on days 1 + 8 of a three-week schedule combined with carboplatin AUC 4 given on day 1. The majority of evaluable patients showed an objective response (62.5%), and median progression-free and overall survival were 10 and 18+ months, respectively. CONCLUSION: Gemcitabine-carboplatin given according to the MTD is well tolerated and active against recurrent platinum-sensitive disease. A randomized trial comparing carboplatin with or without gemcitabine in platinum-sensitive ovarian cancer has already been initiated.
UI - 11759976
AU - Linasmita V; Wilailak S; Thakkinstian A; Srisupundit S; Tangtrakul S;
TI - Israngura N; Bullangpoti S Advanced epithelial ovarian carcinoma in Thai women: should we continue to offer second-look laparotomy?
SO - J Med Assoc Thai 2001 Jul;84(7):958-65
AD - Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
OBJECTIVE: To determine survival among patients with epithelial ovarian carcinoma (EOC) who underwent a second-look laparotomy (SLL) and those refusing the procedure. Also to analyze factor(s) influencing the survival of the patients. METHOD AND MATERIAL: Medical records were reviewed of patients with advanced EOC who were clinically free of disease after primary surgery and platinum-based chemotherapy between January 1, 1992, and December 31, 1998. All of them were offered SLL. Measurement outcomes include patient survival and disease-free survival. RESULTS: There were 50 patients with clinically complete remission after chemotherapy. Sixteen patients underwent SLL, and thirty-four patients refused the procedure (NSLL). Seven patients (43.8%) were reported to have positive SLL. After the median follow-up time of 35 months, 12 patients had died, and 5 patients were lost to follow-up. The median survival time for patients with SLL was about 60 months. Five-year survival rates of patients in the SLL, and NSLL groups were 37 per cent (95%CI = 7%-69%), and 88 per cent (95%CI = 65%-96%) respectively (P<0.001). The median time to relapse was about 25 months for patients with negative SLL. Five-year disease-free survival rates of patients in the negative SLL, and NSLL groups were 28 per cent (95%CI = 4%-59%), and 54 per cent (95%CI = 34%-70%) respectively (P=0.251). By Cox regression analysis, tumor grade was the only significant prognostic factor influencing patients' survival (HR = 6, 95%CI of HR = 1.2-34.2). CONCLUSION: The second-look laparotomy doesn't have a favorable impact on overall and disease-free survival. Tumor grade is the only independent prognostic variable for survival of the patients.
UI - 11780339
AU - Shen M; Feng Y; Ge B; Wu Z; Zhu M
TI - Liposome-C-erbB2 antisense oligodoxynucleotides in human ovarian cancer cells.
SO - Chin Med J (Engl) 2001 Jul;114(7):735-7
AD - Hospital of Obstetrics and Gynecology, Fu Dan University, Shanghai 200011, China.
OBJECTIVE: To explore the effects of liposome-C-erbB2 antisense phosphorothioate oligodeoxynucleotides (S-ODNs) on C-erbB2 proto-oncogene expression and cell proliferation in human ovarian cancer cells. METHODS: The effects of liposome-C-erbB2 S-ODNs on C-erbB2 protein expression, cell cycle and cell proliferation in human ovarian cancer cells were studied by means of flow cytometry and 3H-thymidine incorporation. RESULTS: Liposome-C-erbB2 S-ODNs can specifically reduce C-erbB2 protein expression in human ovarian cancer cells, accompanied by a 30% inhibition of cell proliferation. The effectiveness of liposome-C-erbB2 S-ODNs on the expression of C-erbB2 was about 40 times higher than that of C-erbB2 S-ODNs. CONCLUSIONS: The data suggest that antisense therapy might be a useful method of gene therapy in ovarian cancer. The effectiveness of C-erbB2 S-ODNs could be greatly increased by adsorption of S-ODNs by liposomes.
UI - 11747321
AU - Olaitan A; Weeks J; Mocroft A; Smith J; Howe K; Murdoch J
TI - The surgical management of women with ovarian cancer in the south west of England.
SO - Br J Cancer 2001 Dec 14;85(12):1824-30
AD - Department of Gynaecological Oncology, St Michael's Hospital, Southwell Street, Bristol, BS2 8EG, UK.
The surgical management of epithelial ovarian cancer in the South West of England was studied in the two years 1997-1998 in order to determine the factors that influence the outcome of surgery and to provide a baseline from which to assess the effect of centralisation of cancer services. All hospitals in the South West region of England participating in the Regional Cancer Organisation's longitudinal study of outcomes in gynaecological malignancies are included. Six hundred and eighty-two patients with epithelial ovarian cancer were registered with the RCO in the two-year study period. Five hundred and ninety-five women were offered primary cytoreductive surgery of which 438 were said to be optimally cytoreduced. Applying multivariate models to analyse the outcome of surgery, older patients (OR = 0.82 per 5-year increase in age, P = 0.0003), patients treated in hospitals managing fewer than ten cases of ovarian cancer per year (OR = 1.92, P = 0.02) and patients with FIGO stage 3 (OR = 0.02, P < 0.0001) or 4 (OR = 0.002, P < 0.0001) disease were less likely to be optimally cytoreduced. Gynaecological oncologists were 2.06 times more likely to attain optimal cytoreduction when compared to general gynaecologists and this was statistically significant (P = 0.01). The results from this study support the argument that limiting surgery for ovarian malignancy to specialised surgeons improves the extent of cytoreductive surgery.
UI - 11776033
AU - Sun T; Feng Y; Zhu Y; Zheng Y
TI - Therapeutic strategy in the management of stage II-IV epithelial ovarian carcinoma.
SO - Chin Med J (Engl) 2000 Jul;113(7):625-7
AD - Department of Obstetrics and Gynecology, Shanghai First People's Hospital, Shanghai 200080, China.
OBJECTIVE: To investigate the optimal time of debulking in stage/II to stage IV epithelial ovarian carcinoma, considering corresponding patients were treated under two different regimens. Group A-76 cases (2 cases in IIa stage, 4 cases in IIb stage, 6 cases in IIc stage, 58 cases in IIIc stage and 7 cases in IV stage) was managed according to a traditional surgery-chemotherapy regimen; and group B-19 cases (17 cases in IIIc stage and 2 cases in IV stage) was managed with a chemotherapy-surgery-chemotherapy regimen. RESULTS: The optimal debulking rate (no macroscopic residual or residual < 2 cm) in group A was significantly lower than in group B, being 32.9% (25/76) and 68.4% (13/19), respectively (P < 0.001). The average survival time of those with a residual focus > 2 cm was shorter than those with a residual focus < 2 cm, in both groups. Sixteen out of the 51 patients with a residual focus > 2 cm had a second debulking operation, among whom 7 had preoperative chemotherapy. All of these 7 patients had either no residuals or residual < 2 cm. In 9 cases without preoperative chemotherapy, the residuals were all > 2 cm. The average survival time among these two groups were significantly different (P < 0.01). CONCLUSION: (1) For those patients in whom optimal debulking was clinically assessed to be possible, timely operation is mandatory. (2) For those inoperable advanced cases, chemotherapy-surgery-chemotherapy regimen is recommended. (3) For those with residuals > 2 cm and were assessed to be difficult to eradicate during second-look operation, multi-route chemotherapy (intro-arterial, intraperitoneal, and systematic) should be given before going on the second debulking operation. Positive attitude and proper regimen would offer better results. (4) A multicenter prospective study would give more decisive conclusion.
UI - 11677421
AU - Balbi GC; Menditto A; Calabria G; Musone R; Di Prisco L; Cassese E;
TI - Balbi C; Cardone A Paclitaxel and carboplatin as outpatient therapy for stage III and IV epithelial ovarian cancer.
SO - Panminerva Med 2001 Dec;43(4):263-5
AD - Institute of Obstetrics and Gynecology, Second University of Studies of Naples, Naples, Italy.
BACKGROUND: To determine the toxicity and the response rate of a three-hour paclitaxel infusion and carboplatin administered as outpatient treatment for stage III and IV epithelial ovarian cancer. METHODS: Forty-three patients with stage III/IV epithelial ovarian cancer underwent cytoreductive surgery and then received paclitaxel 175 mg/m2 over 3-hr infusion and carboplatin AUC5 every 21 days for six cycles. Elegible patients had adequate bone marrow, renal and hepatic function; G-CSF was recommended if white cell count fell under 3,000/mm3. RESULTS: No patients had hypersensivity reactions; 15 out of 43 patients (35%) required colony-stimulating factors, 39 patients (91%) had general alopecia, three patients (7%) had severe emesis, 20 patients (46%) had mild emesis, four patients (9%) had severe myalgias, eight patients (18%) had moderate myalgias, one patient (2%) had grade 3 neurotoxicity. Three patients experienced grade 3 thrombocytopenia (7%). At a median follow-up of 29 months, 32 of 43 patients are alive (74%). Median progression-free survival is 14 months. Median overall survival has not been reached. CONCLUSIONS: Three-hour infusion paclitaxel and carboplatin is an effective and safe outpatient therapy for epithelial ovarian cancer.
UI - 11697824
AU - Piccart MJ; Lamb H; Vermorken JB
TI - Current and future potential roles of the platinum drugs in the treatment of ovarian cancer.
SO - Ann Oncol 2001 Sep;12(9):1195-203
AD - Jules Bordet Institute, Chemotherapy Unit, Brussels, Belgium. firstname.lastname@example.org
The discovery of cisplatin more than two decades ago was the most important therapeutic advance in the treatment of ovarian cancer. Today, cisplatin or carboplatin in combination with paclitaxel is the most commonly used first-line treatment for patients with advanced ovarian cancer. Although platinum drugs remain a critical component of chemotherapy in this type of cancer, cumulative toxicities can limit their use. These toxicities include nephrotoxicity, neurotoxicity and ototoxicity with cisplatin and myelosuppression with carboplatin. Although these adverse events can often be managed, the interventions themselves can complicate and add to the costs of treatment. Importantly, acquired resistance to traditional platinum drugs often develops in patients with ovarian cancer and can limit the usefulness of these drugs. Research into new platinum drugs has focused on identifying compounds with improved tolerability profiles and, importantly, those which can circumvent mechanisms of platinum resistance. New platinum drugs currently under development that are showing promise in ovarian cancer include oxaliplatin, nedaplatin, satraplatin, BBR3464 and ZD0473. If the encouraging in vitro activity shown by new compounds, such as ZD0473 and BBR3464, translates into efficacy in the clinic, they may offer an extended spectrum of activity which includes patients with ovarian cancer resistant to the classical platinum drugs.
UI - 11783024
AU - Feng F; He X; Shi Y
TI - [Clinical study of topotecan in the treatment of small cell lung cancer and recurrent ovarian cancer]
SO - Zhonghua Zhong Liu Za Zhi 2001 Mar;23(2):155-8
AD - Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
OBJECTIVE: To evaluate the effect and adverse reaction of China made topotecan in the treatment of small-cell lung cancer (ACLC) and recurrent ovarian cancer (OV). METHODS: From January to July, 2000, topotecan was used to treat 141 patients at a dose of 1.2 mg/m2, given daily as 30-min i.v. infusion for 5 days. Treatment was repeated once every 3 weeks. Of the 141 patients, 118 were evaluable for therapeutic efficacy. All the patients received a total of 286 cycles of treatment were assessable for analysis of adverse reactions. RESULTS: Among the evaluable patients, there were 5 CR, 35 PR, with an overall response rate (RR) of 33.8%. There were 3 CR and 26 PR in 89 patients with SCLC (RR 32.5%). The response rate of patients with or without prior chemotherapy was 15.6% and 50%, respectively. In 29 patients with recurrent OV, there were 2 CR and 9 PR (RR 37.9%). The major toxic effect was myelosuppression. Non-hematopoietic toxicities were mild and tolerable. CONCLUSION: Topotecan is an effective drug for the treatment of SCLC and recurrent OV. It is still efficacious in some patients who previously received standard chemotherapy. The major dose-limiting toxicity is myelosuppression. The response rate and toxicity of the domestically made topotecan are comparable with those of the imported one.
UI - 11795947
AU - Woolley DE; Tetlow LC; Adlam DJ; Gearey D; Eden RD; Ward TH; Allen TD
TI - Electrochemical monitoring of anticancer compounds on the human ovarian carcinoma cell line A2780 and its adriamycin- and Cisplatin-resistant variants.
SO - Exp Cell Res 2002 Feb 1;273(1):65-72
AD - University Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, United Kingdom. email@example.com
A novel electrochemical technique which detects and monitors real-time changes in cell behavior in vitro has been used to examine the effects of recognized anticancer drugs on the human ovarian carcinoma cell line A2780 and its adriamycin (A2780adr)- and cisplatin (A2780cispt)-resistant variants. These cells, adherent to gold electrodes or sensors, modify the extracellular microenvironment at the cell:sensor interface, producing an electrochemical potential that is different from that of the bulk culture medium. Confluent, adherent A2780 cells produced an electrochemical signal, measured as an open circuit potential (OCP), of approximately -100 mV compared to a cell-free value of approximately -15 mV. Exposure of A2780 cells to cisplatin (range 10(-4) to 10(-6) M), adriamycin (range 10(-5) to 10(-7) M), and vinblastine (10(-6) M) all produced positive shifts in the OCP signal relative to untreated control cells during 24 h of culture, but Taxotere (range 10(-5) to 10(-7) M) had no effect. These positive shifts in OCP signal were evident well before observations of reduced cellular adhesion and viability after 24 h, as judged in parallel cultures with a plastic substratum and by scanning electron microscopy. By contrast, the same treatments applied to the A2780adr and A2780cispt variants showed that each demonstrated different sensitivities to the same drugs applied to the parental A2780 cells. The effects of the same four anticancer drugs on ovarian carcinoma (A2780) and breast carcinoma (8701-BC) cell lines showed that the former was far more responsive to adriamycin and cisplatin. Such differences in drug sensitivities between the two cell lines were subsequently confirmed using the conventional MTT assay over 5 days. Although this electrochemical technology readily detects changes in cell adhesion and viability, the modified OCP signals recorded within a few hours of anticancer drug treatments are evident well before microscopic morphological changes become apparent. It is proposed that these early changes in OCP signals, relative to control untreated cells, reflect modifications of physiological/behavioral processes manifested at the cell surface. Copyright 2001 Elsevier Science.
UI - 10963637
AU - Gordon AN; Granai CO; Rose PG; Hainsworth J; Lopez A; Weissman C;
TI - Rosales R; Sharpington T Phase II study of liposomal doxorubicin in platinum- and paclitaxel-refractory epithelial ovarian cancer.
SO - J Clin Oncol 2000 Sep;18(17):3093-100
AD - Physicians Reliance Network, Dallas, TX, USA. firstname.lastname@example.org
PURPOSE: Stealth liposomal doxorubicin (Alzal Corp, Palo Alto, CA) has a slower clearance rate than free doxorubicin, resulting in sustained serum levels. Liposomal encapsulation also leads to increased concentration of drug in tumor tissue. Meta-analysis of previous studies has shown that doxorubicin has activity in epithelial ovarian cancer. The current study was developed to examine the activity of Stealth liposomal doxorubicin in platinum- and paclitaxel-refractory ovarian cancer. PATIENTS AND METHODS: Patients had epithelial ovarian cancer that either progressed on or recurred within 6 months of completion of platinum and paclitaxel chemotherapy. All patients had measurable disease. Stealth liposomal doxorubicin was administered at 50 mg/m(2) every 4 weeks as a 1-hour infusion. RESULTS: Eighty-nine patients were treated and included in an intent-to-treat analysis. There were 82 patients who were platinum and paclitaxel refractory and met all study criteria. There was one complete response and 14 partial responses, for a total response rate of 16.9% (95% confidence interval [CI], 9.1% to 24.6%). For platinum- and paclitaxel-refractory patients, the response rate was 18.3% (95% CI, 9.9% to 26.7%). Median time to progression was 19. 3 weeks for the entire population. Ten patients (11.2%) withdrew because of adverse events related to the drug (palmar-plantar erythrodysesthesia [PPE], n = 3; asthenia, n = 2; cardiac, n = 2; neutropenia, n = 1; stomatitis, n = 1; and edema, n = 1). There were no drug-related fatal events. There were only eight grade 4 adverse events attributable to the drug. Stomatitis, PPE, and skin lesions were managed with dose reductions and delays in most cases. CONCLUSION: Stealth liposomal doxorubicin has activity in refractory epithelial ovarian cancer. PPE and stomatitis can usually be managed by dose adjustment. The ease of administration makes this an attractive agent.
UI - 11695811
AU - Recchi F; De Filippis S; Rosselli M; Saggio G; Carta G; Rea S
TI - Primary chemotherapy in stage IV ovarian cancer. A prospective phase II study.
SO - Eur J Gynaecol Oncol 2001;22(4):287-91
AD - Oncologic Unit, Avezzano, Italy.
BACKGROUND AND RATIONALE: Non-curative surgical cytoreduction of advanced tumors is associated with increased proliferation of the remaining tumor cells. Thus, appropriate preoperative chemotherapy should prevent both cell proliferation and the increase of resistant cells. The aim of the present study was to evaluate the efficacy and toxicity of primary chemotherapy (P-CT) in previously untreated patients with stage IV ovarian cancer (OC). PATIENTS AND METHODS: Thirty-four with P-CT. Eligibility criteria included: histologically or cytologically confirmed, unresectable stage IV OC and performance status < or = 3. P-CT consisted of four courses of carboplatin, carboplatin thereafter. Surgery followed P-CT. After the operation patients received two further courses of chemotherapy that were tailored according to their individual response. Median (M) age was 61 years, range 32-73; median performance status was 2. A total number of 197 courses of CT were administered, median 5.7 per patient. RESULTS: Complete or partial response (CR, PR) was observed in 28 patients (response rate 82%, 95% CI: 65.4% to 93.2%), disease stability and progression (SD, PD) was observed in three and three patients, respectively. Median time to progression was 16.45 months (range 4.8-90.4+), median survival time was 28 months (range 4.5 - 90.4+): 1-year survival rate was 94%. Toxicity according to WHO: nausea and vomiting grade (G) 2, 30% of patients; gastrointestinal G 2-3, 20% of patients; alopecia G 3, 88% of patients; hematological G 3-4, 73% of patients; neurologic G 2, 12% of patients. Nine pathological CRs were observed. CONCLUSION: Neoadjuvant treatment with CBDCA with either CTX