Abstract
Objective The aim of the present study was to evaluate the impact of a multidisciplinary approach in patients' selection with advanced ovarian cancer (AOC) for different therapeutic strategies. Methods Patients referred at our institution between 2009 and 2012 for AOC were included. Primary multidisciplinary evaluation was performed in all patients. Different strategies included: 1. patients referred to primary neoadjuvant chemotherapy (NACT) and interval surgery (IDS) (group A); 2. patients considered for surgical exploration. After surgical exploration, patients were either considered for primary debulking (PDS; group B), or NACT (group C). Results A total of 363 patients were included. Of 38 patients (10.5%) in group A, 24 (63%) had sovradiaphragmatic/multiple liver metastases; 14 (37%) were excluded for PDS for anestehesiologic/medical reasons. Of 325 (89.5%) considered for surgical exploration, 295 (91%; group B) had primary surgery with debulking intent (N: 277) and were cytoreduced to no macroscopic disease (R0: N:200; 68%) o minimal RD < 5 mm (R1: N:77; 26%) or palliative intent (N:18; 6%); 30 (9%; group C) were referred for NACT. Of those, 27 (90%) underwent IDS, 3 had progressive disease. Overall survival (OS) and progression free survival (PFS) was different between the groups: OS: Group A: 34 months; Group B: 59 months; Group C: 29 months; p < 0.001. PFS: Group A: 10 months; Group B; 21 months; Group C: 12 months; p < 0.001. Conclusions A multidisciplinary approach to patients referred to a tertiary center with AOC allows optimization of the treatment strategy, based on patients' characteristics (age, performance/nutritional status, comorbidities, functional status) and tumor diffusion (evaluated pre- and intraoperatively).
| Original language | English |
|---|---|
| Pages (from-to) | 468-473 |
| Number of pages | 6 |
| Journal | Gynecologic Oncology |
| Volume | 144 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2017 |
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ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynaecology
Cite this
Multidisciplinary approach in the management of advanced ovarian cancer patients : A personalized approach. Results from a specialized ovarian cancer unit. / Aletti, Giovanni Damiano; Garbi, Annalisa; Messori, Pietro; Achilarre, Maria Teresa; Zanagnolo, Vanna; Rizzo, Stefania; Alessi, Sarah; Bocciolone, Luca; Landoni, Fabio; Biffi, Roberto; Carinelli, Silvestro; Colombo, Nicoletta; Maggioni, Angelo.
In: Gynecologic Oncology, Vol. 144, No. 3, 01.03.2017, p. 468-473.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multidisciplinary approach in the management of advanced ovarian cancer patients
T2 - A personalized approach. Results from a specialized ovarian cancer unit
AU - Aletti, Giovanni Damiano
AU - Garbi, Annalisa
AU - Messori, Pietro
AU - Achilarre, Maria Teresa
AU - Zanagnolo, Vanna
AU - Rizzo, Stefania
AU - Alessi, Sarah
AU - Bocciolone, Luca
AU - Landoni, Fabio
AU - Biffi, Roberto
AU - Carinelli, Silvestro
AU - Colombo, Nicoletta
AU - Maggioni, Angelo
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objective The aim of the present study was to evaluate the impact of a multidisciplinary approach in patients' selection with advanced ovarian cancer (AOC) for different therapeutic strategies. Methods Patients referred at our institution between 2009 and 2012 for AOC were included. Primary multidisciplinary evaluation was performed in all patients. Different strategies included: 1. patients referred to primary neoadjuvant chemotherapy (NACT) and interval surgery (IDS) (group A); 2. patients considered for surgical exploration. After surgical exploration, patients were either considered for primary debulking (PDS; group B), or NACT (group C). Results A total of 363 patients were included. Of 38 patients (10.5%) in group A, 24 (63%) had sovradiaphragmatic/multiple liver metastases; 14 (37%) were excluded for PDS for anestehesiologic/medical reasons. Of 325 (89.5%) considered for surgical exploration, 295 (91%; group B) had primary surgery with debulking intent (N: 277) and were cytoreduced to no macroscopic disease (R0: N:200; 68%) o minimal RD < 5 mm (R1: N:77; 26%) or palliative intent (N:18; 6%); 30 (9%; group C) were referred for NACT. Of those, 27 (90%) underwent IDS, 3 had progressive disease. Overall survival (OS) and progression free survival (PFS) was different between the groups: OS: Group A: 34 months; Group B: 59 months; Group C: 29 months; p < 0.001. PFS: Group A: 10 months; Group B; 21 months; Group C: 12 months; p < 0.001. Conclusions A multidisciplinary approach to patients referred to a tertiary center with AOC allows optimization of the treatment strategy, based on patients' characteristics (age, performance/nutritional status, comorbidities, functional status) and tumor diffusion (evaluated pre- and intraoperatively).
AB - Objective The aim of the present study was to evaluate the impact of a multidisciplinary approach in patients' selection with advanced ovarian cancer (AOC) for different therapeutic strategies. Methods Patients referred at our institution between 2009 and 2012 for AOC were included. Primary multidisciplinary evaluation was performed in all patients. Different strategies included: 1. patients referred to primary neoadjuvant chemotherapy (NACT) and interval surgery (IDS) (group A); 2. patients considered for surgical exploration. After surgical exploration, patients were either considered for primary debulking (PDS; group B), or NACT (group C). Results A total of 363 patients were included. Of 38 patients (10.5%) in group A, 24 (63%) had sovradiaphragmatic/multiple liver metastases; 14 (37%) were excluded for PDS for anestehesiologic/medical reasons. Of 325 (89.5%) considered for surgical exploration, 295 (91%; group B) had primary surgery with debulking intent (N: 277) and were cytoreduced to no macroscopic disease (R0: N:200; 68%) o minimal RD < 5 mm (R1: N:77; 26%) or palliative intent (N:18; 6%); 30 (9%; group C) were referred for NACT. Of those, 27 (90%) underwent IDS, 3 had progressive disease. Overall survival (OS) and progression free survival (PFS) was different between the groups: OS: Group A: 34 months; Group B: 59 months; Group C: 29 months; p < 0.001. PFS: Group A: 10 months; Group B; 21 months; Group C: 12 months; p < 0.001. Conclusions A multidisciplinary approach to patients referred to a tertiary center with AOC allows optimization of the treatment strategy, based on patients' characteristics (age, performance/nutritional status, comorbidities, functional status) and tumor diffusion (evaluated pre- and intraoperatively).
UR - http://www.scopus.com/inward/record.url?scp=85009792106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85009792106&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2017.01.017
DO - 10.1016/j.ygyno.2017.01.017
M3 - Article
C2 - 28117100
AN - SCOPUS:85009792106
VL - 144
SP - 468
EP - 473
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -