Abstract

The choice of treatment strategy in patients with stage IIIC‑IV ovarian cancer (OC) remains the subject of numerous discussions. The reason for this is the unsatisfactory results of randomized trials and the low frequency of primary complete debulking surgery in these studies. We conducted a retrospective analysis to evaluate the survival outcomes in patients with OC stage IIIC–IV (n=314) who underwent treatment between 1995 and 2017. The median progression free survival for primary surgery was 15.6 months, after interval debulking – 11.5 months (p=0.002, HR 0.61: 95 % CI 0.39–0.81). The primary cytoreduction significantly increased the median of overall survival by 19.6 months: from 38.0 months after interval debulking up to 57.6 months after primary cytoreduction (p=0.04, HR 0.64: 95 % CI 0.41–0.99). An increase in the number of optimal interval debulking does not lead to an improvement in the long-term results of treatment in the group of patients after neoadjuvant chemotherapy. Our analysis over the past 20 years has shown that improvement in treatment outcomes is only observed in the primary cytoreduction group due to an increase in the number of complete optimal cytoreductive surgery.

Highlights

  • The reason for this is the unsatisfactory results of randomized trials

  • The primary cytoreduction significantly increased the median of overall survival by 19.6 months

  • An increase in the number of optimal interval debulking does not lead to an improvement in the long-term results

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Summary

Первичная циторедукция

Отдаленные результаты лечения больных РЯ IIIС–IV стадий в зависимости от сроков выполнения циторедукции. Мы разделили больных в зависимости от времени выполнения циторедукции на два периода: 1995–2005 и 2006–2017 гг. Цель данного анализа включала изучение эволюции лечения больных РЯ IIIС–IV стадий в РОНЦ им. В первый период попали 76 больн­ ых, получавших лечение с 1995 по 2005 г. За второй период с 2006 по 2017 г. 2 продемонстрирована сравнительная характеристика основных показателей у больных РЯ IIIС–IV стадий в зависимости от периода лечения. В первом периоде почти половина больных бы­ ла представлена диссеминированной болезнью (44,7 %), Ретроспективный анализ отдаленных результатов применения первичной циторедукции и предоперационной химиотерапии на первом этапе лечения больных IIIC–IV стадий рака яичника. Клинико-морфологическая характеристика больных РЯ IIIС–IV стадий в зависимости от периода лечения

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