Ovarian Cysts and Ovarian Cancer

Ovarian cysts and tumours are a relatively common finding among women of many ages, particularly with the wider use of regular physical examinations and ultrasound. Most cysts and tumours in younger women are not malignant and can often be managed entirely within primary care. However, malignant tumours also occur. The average GP will see a new case of ovarian cancer every 4 to 5 years. Ovarian cancer is the second most common cancer of the female genital tract and the leading cause of death due to gynaecological malignancy. Ovarian cancer is frequently diagnosed at a late stage and carries a poor prognosis. Guidance published by the National Institute for Health and Clinical Excellence (NICE) in 2011 recognises this fact and recommends changes to the way in which cases are detected and managed in primary care. This article is a revision of a previous InnovAiT publication, incorporating recent changes to recommended practice

PREDICTORS OF SURVIVAL IN PATIENTS WITH RECURRENT OVARIAN CANCER UNDERGOING SECONDARY CYTOREDUCTIVE SURGERY BASED ON AN INTERNATIONAL COLLABORATIVE ANALYSIS

PREDICTORS OF SURVIVAL IN PATIENTS WITH RECURRENT OVARIAN CANCER UNDERGOING SECONDARY CYTOREDUCTIVE SURGERY BASED ON AN INTERNATIONAL COLLABORATIVE ANALYSIS R.-Y. Zang1, P. Harter2, D.S. Chi3, J. Sehouli4, R. Jiang1, C.G. Tropé5, A. Ayhan6, G. Cormio7, Y. Xing8, K. Wollschlaeger9, E.I. Braicu4, C.A. Rabbitt3, H. Oksefjell5, W.-J. Tian1, C. Fotopoulou4, J. Pfisterer10, A. du Bois2, J.S. Berek11 1Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Cancer Hospital, Shanghai, China, 2Department of Gynecology & Gynecologic Oncology, HSK, Dr. Horst Schmidt Klinik, Wiesbaden, Germany, 3Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA, 4Department of Gynecology, Charité Medical University of Berlin, Berlin, Germany, 5Division of Gynecology and Obstetrics, Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo, Norway, 6Department of Obstetrics and Gynecology, Baskent University Faculty of Medicine, Ankara, Turkey, 7Department of Gynecology, Obstetrics and Neonatology, University of Bari, Bari, Italy, 8Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, 9Department of Gynecology and Obstetrics, University of Magdeburg, Magdeburg, 10Department of Gynecology and Obstetrics, Hospital Solingen, Solingen, Germany, 11Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford Cancer Center, Stanford University School of Medicine, Stanford, CA, USA Background: This study aims to identify prognostic factors and to develop a risk model predicting survival in patients undergoing secondary cytoreductive surgery (SCR) for recurrent epithelial ovarian cancer. Methods: Individual data of 1,100 patients with recurrent ovarian cancer of a progression-free interval at least 6 months who underwent SCR were pooled analyzed. A simplified scoring system for each independent prognostic factor was developed according to its coefficient. Internal validation was performed to assess the discrimination of the model. Results: Complete SCR was strongly associated with the improvement of survival, with a median survival of 57.7 months, when compared to 27.0 months in those with residual disease of 0.1-1cm and 15.6 months in those with residual disease of >1cm, respectively (P< 0.0001). Progression-free interval (< 23.1 months vs. >=23.1 months, hazard ratio (HR),1.72; score: 2), ascites at recurrence (present vs. absent, HR, 1.27; score: 1), extent of recurrence (multiple vs. localized disease, HR, 1.38; score: 1) as well as residual disease after SCR (R1 vs. R0, HR, 1.90, score: 2; R2 vs. R0, HR,3.0, score: 4) entered into the risk model. Conclusion: This prognostic model may provide evidence to predict survival benefit from secondary cytoreduction in patients with recurrent ovarian cancer