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1. Harter P, du Bois A, Schade-Brittinger C, Burges A, Wollschlaeger K, Gropp M, Schmalfeldt B, Huober J, Staehle A, Pfisterer J: Non-enrolment of ovarian cancer patients in clinical trials: reasons and background. Ann Oncol; 2005 Nov;16(11):1801-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Non-enrolment of ovarian cancer patients in clinical trials: reasons and background.
  • PATIENTS AND METHODS: We evaluated the reasons for non-enrolment of ovarian cancer patients in clinical trials.
  • All patients with ovarian cancer not enrolled in clinical studies and treated in 2001 in the participating centres were documented retrospectively and compared with patients enrolled in clinical trials at the same institutions during the same time period.
  • RESULTS: Two hundred and seventy-four patients with advanced ovarian cancer (FIGO stage IIB-IV) were included, of whom 139 (51%) and 135 (49%) patients were enrolled in this study and in prospective clinical trials, respectively.
  • However, 62% of the non-study patients were treated with the same chemotherapy as in the standard arm of the respective clinical studies.

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  • (PMID = 16091427.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 7M7YKX2N15 / Topotecan; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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2. Kommoss S, Schmidt D, Kommoss F, Hedderich J, Harter P, Pfisterer J, du Bois A: Histological grading in a large series of advanced stage ovarian carcinomas by three widely used grading systems: consistent lack of prognostic significance. A translational research subprotocol of a prospective randomized phase III study (AGO-OVAR 3 protocol). Virchows Arch; 2009 Mar;454(3):249-56
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Histological grading in a large series of advanced stage ovarian carcinomas by three widely used grading systems: consistent lack of prognostic significance. A translational research subprotocol of a prospective randomized phase III study (AGO-OVAR 3 protocol).
  • While there is no doubt that histologic grading is applicable in early stage ovarian carcinoma, it is still in controversial discussion concerning advanced stage ovarian carcinoma.
  • It was the aim of this study to assess the three most widely used grading systems for ovarian carcinoma in terms of prognostic significance, concordance rates, and reproducibility in a large number of advanced stage ovarian carcinomas of all types after standardized chemotherapy.
  • Representative hematoxylin and eosin slides from 334 cases of stage IIB-IV ovarian carcinoma (prospective randomized, multi-center, phase III study) were used.
  • The first round was grading of all cases according to FIGO, GOG, and Silverberg by one author.
  • None of the three grading systems was prognostically significant (FIGO p = 0.38; GOG p = 0.70; Silverberg p = 0.92).
  • The concordance rates between the three systems were as follows: FIGO/GOG 95.5%, kappa = 0.929; Silverberg/FIGO 69.9%, kappa = 0.533; Silverberg/GOG 66.8%, kappa = 0,481.
  • Grading of advanced stage ovarian carcinomas was of no value for estimation of prognosis in this homogeneously treated patient group.
  • [MeSH-major] Ovarian Neoplasms / pathology

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  • (PMID = 19172293.001).
  • [ISSN] 1432-2307
  • [Journal-full-title] Virchows Archiv : an international journal of pathology
  • [ISO-abbreviation] Virchows Arch.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Germany
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3. Hilpert F, Krause G, Venhoff L, Kühnle E, Schem C, Maass N: [Epithelial ovarian cancer]. Ther Umsch; 2007 Jul;64(7):375-80
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  • [Title] [Epithelial ovarian cancer].
  • Ovarian cancer (OC) is associated with the highest cancer-related mortality among gynecological cancers, since nearly 2/3 of patients are diagnosed with advanced stage disease which is caused by an unspecific clinical appearance and the lack of effective early detection methods.
  • So far only histopathological and clinical prognostic factors have clinical relevance from which FIGO-stage and the postoperative residual disease have predominant importance.
  • Early stage OC (FIGO Ia-II) has a good prognosis with survival rates of approximately 90%, provided that the tumor is macroscopically resected and an adequate surgical staging has been performed.
  • Additionally early stage OC patients should receive an adjuvant platinum-based chemotherapy.
  • In advanced stage OC (FIGO IIb-IV) the aim of primary surgery is a maximum cytoreduction.
  • Additionally, postoperative treatment is performed with carboplatin/paclitaxel for six cycles.
  • So far there are no data to support the introduction of non-cross-resistant agents, dose escalation or prolongation of therapy.
  • The majority of advanced stage patients relapse despite optimal primary therapy.
  • Treatment of recurrent disease follows palliative considerations and should serve symptom control and tumor regression and especially quality of life.
  • The prognosis of recurrent disease differs extensively according to the length of the progression-free survival and response to primary platinum-based chemotherapy and is differentiated into platinum-refractory and platinum-sensitive disease.
  • In contrast, platinum-sensitive recurrent OC have a much more favourable prognosis due to response rates of 30-50% with platinum-based combination therapies.
  • Another operation seems to be only reasonable in case of platinum-sensitive recurrent disease and if the tumor can be macroscopically resected with no residual tumor The aftercare in OC should focus on the detection of recurrent disease and the detection and therapy of maintained treatment related toxicities as well as psycho-oncological aspects.
  • [MeSH-major] Neoplasms, Glandular and Epithelial. Ovarian Neoplasms
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. CA-125 Antigen / blood. Chemotherapy, Adjuvant. Clinical Trials as Topic. Female. Humans. Incidence. Meta-Analysis as Topic. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Ovary / pathology. Postoperative Care. Prognosis. Time Factors

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  • (PMID = 17948754.001).
  • [ISSN] 0040-5930
  • [Journal-full-title] Therapeutische Umschau. Revue thérapeutique
  • [ISO-abbreviation] Ther Umsch
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / CA-125 Antigen
  • [Number-of-references] 28
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4. Kommoss F, Kommoss S, Schmidt D, Trunk MJ, Pfisterer J, du Bois A, Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom: Survival benefit for patients with advanced-stage transitional cell carcinomas vs. other subtypes of ovarian carcinoma after chemotherapy with platinum and paclitaxel. Gynecol Oncol; 2005 Apr;97(1):195-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Survival benefit for patients with advanced-stage transitional cell carcinomas vs. other subtypes of ovarian carcinoma after chemotherapy with platinum and paclitaxel.
  • OBJECTIVE: Transitional cell carcinoma (TCC) of the ovary is a less well recognized histological type of ovarian carcinoma resembling TCC of the urinary bladder.
  • A better prognosis due to a better chemosensitivity of ovarian TCC has been suggested.
  • It was the aim of the present retrospective study to compare incidence and outcome of patients with TCCs and other subtypes of ovarian carcinoma from a large homogeneous collective of patients with primary advanced-stage ovarian carcinoma.
  • METHODS: H and E-stained sections from a total of 302 cases from a prospective randomized, multi-center, phase III study of patients with ovarian cancer, FIGO-stages IIB-IV, comparing cisplatin plus paclitaxel (PT) with paclitaxel plus carboplatin (TC) were available for histological retyping of ovarian carcinomas applying current WHO criteria.
  • 5-year survival of patients with TCC was 57% as compared to 31% for patients with ovarian carcinomas of other types (P = 0.03).
  • CONCLUSION: TCC of the ovary seems to be a less well recognized entity.
  • In the current series, TCCs had a significantly better prognosis as compared to all other types of ovarian carcinomas after standardized chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Transitional Cell / drug therapy. Ovarian Neoplasms / drug therapy

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  • (PMID = 15790458.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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5. Hilpert F, du Bois A, Greimel ER, Hedderich J, Krause G, Venhoff L, Loibl S, Pfisterer J: Feasibility, toxicity and quality of life of first-line chemotherapy with platinum/paclitaxel in elderly patients aged >or=70 years with advanced ovarian cancer--a study by the AGO OVAR Germany. Ann Oncol; 2007 Feb;18(2):282-7
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  • [Title] Feasibility, toxicity and quality of life of first-line chemotherapy with platinum/paclitaxel in elderly patients aged >or=70 years with advanced ovarian cancer--a study by the AGO OVAR Germany.
  • BACKGROUND: The purpose of the study was to evaluate first-line platinum/paclitaxel (Taxol) under phase III trial conditions in ovarian cancer (OC) patients aged >or=70 years.
  • PATIENTS AND METHODS: Phase III results of 779 patients with OC International Federation of Gynecology and Obstetrics (FIGO) stage IIB/IV treated with cisplatin/paclitaxel versus carboplatin/paclitaxel were retrospectively analyzed according to feasibility, toxicity (National Cancer Institute Common Toxicity Criteria) and quality of life (QoL) [European Organization for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30)] in patients aged <70 or >or=70 years.
  • Patient characteristics (<70 versus >or=70 years) showed significant differences with regard to Eastern Cooperative Oncology Group performance status, residual disease and constitutional factors but not to FIGO stage, histology or grading.
  • CONCLUSION: Platinum/paclitaxel appeared to be feasible and tolerable in elderly patients under clinical trial conditions, but there seems to be a different investigators' estimation of toxicity and less intention to maintain trial treatment in elderly.

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  • (PMID = 17082513.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
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6. Angioli R, Palaia I, Damiani P, Montera R, Benedetti Panici P: [Up-date on cytoreductive surgery in the management of advanced ovarian cancer]. Minerva Ginecol; 2006 Dec;58(6):459-70
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  • [Title] [Up-date on cytoreductive surgery in the management of advanced ovarian cancer].
  • [Transliterated title] Aggiornamenti in tema di citoriduzione nel trattamento del carcinoma ovarico avanzato.
  • Epithelial ovarian cancer represents the most aggressive neoplasm of women genital apparatus with a total 5-year survival rate ranging from 17% to 35% if the disease is in the metastatic phase.
  • Therefore, in 70% of the cases, the diagnosis is done when tumor is already in advanced phase (Stage FIGO IIB-IV).
  • Data from international literature suggest that standard treatment for advanced ovarian cancer is optimal cytoreductive surgery with adjuvant chemotherapy platinum-based.
  • However, in the last decades, many authors have described the enthusiastic results of neoadjuvant chemotherapy and interval debulking surgery.
  • Nevertheless, surgery for ovarian cancer turns out to be a particularly aggressive surgery that needs an operator's remarkable technical ability and a cultural Background: Many studies demonstrated that the frequency of feasibility of optimal cytoreductive surgery also varies within the gynecologic oncology specialized centers.
  • Ovarian cancer turns out to be a particularly chemosensitive tumor.
  • Its responsiveness has been the object of numerous studies and protocols in literature, such as European Organisation of Research and Treatment of Cancer (EORTC) and Gynecologic Oncology Group (GOG) trials.
  • [MeSH-major] Ovarian Neoplasms / surgery
  • [MeSH-minor] Chemotherapy, Adjuvant. Disease Progression. Female. Gynecologic Surgical Procedures / methods. Humans. Neoadjuvant Therapy. Prognosis

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  • (PMID = 17108876.001).
  • [ISSN] 0026-4784
  • [Journal-full-title] Minerva ginecologica
  • [ISO-abbreviation] Minerva Ginecol
  • [Language] ita
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 43
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7. Kommoss S, du Bois A, Ridder R, Trunk MJ, Schmidt D, Pfisterer J, Kommoss F, AGO-OVAR: Independent prognostic significance of cell cycle regulator proteins p16(INK4a) and pRb in advanced-stage ovarian carcinoma including optimally debulked patients: a translational research subprotocol of a randomised study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group. Br J Cancer; 2007 Jan 29;96(2):306-13
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  • [Title] Independent prognostic significance of cell cycle regulator proteins p16(INK4a) and pRb in advanced-stage ovarian carcinoma including optimally debulked patients: a translational research subprotocol of a randomised study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group.
  • The purpose of the study is to test the hypothesis that expression of cell cycle regulatory proteins p16(INK4a) and pRb is significantly associated with prognosis in ovarian carcinomas.
  • We performed immunohistochemical analysis of p16(INK4a) and pRb expression and correlated with survival in a series of 300 patients with FIGO stage IIb-IV ovarian carcinoma which were enrolled in a randomized prospective trial evaluating two different platinum and paxlitaxel chemotherapy combinations after radical surgery. p16(INK4a) negative tumours (17/300; 6%) had a significantly worse prognosis (univariate analysis, P<0.001; multivariate analysis: odds ratio 2.41, P=0.009).
  • In conclusion p16(INK4a) and pRb are independent prognostic factors in advanced-stage ovarian carcinomas after radical surgery and postoperative chemotherapy.
  • High pRb expression is a significant prognosticator in optimally debulked patients and may hold potential for subgroup stratification in postoperative treatment.
  • [MeSH-major] Cyclin-Dependent Kinase Inhibitor p16 / physiology. Ovarian Neoplasms / metabolism. Retinoblastoma Protein / physiology
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Prognosis. Prospective Studies. Survival Rate

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  • (PMID = 17242700.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / Retinoblastoma Protein
  • [Other-IDs] NLM/ PMC2360015
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8. Du Bois A, Rochon J, Lamparter C, Pfisterer J, AGO Organkommission OVAR PFisterer: Pattern of care and impact of participation in clinical studies on the outcome in ovarian cancer. Int J Gynecol Cancer; 2005 Mar-Apr;15(2):183-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pattern of care and impact of participation in clinical studies on the outcome in ovarian cancer.
  • The purpose of this study was to evaluate the pattern and quality of care for ovarian cancer in Germany and analyze prognostic factors with emphasis on characteristics of treating institutions, hospital volume, and participation in clinical trials.
  • This study utilized national survey including patients with histologically proven invasive epithelial ovarian cancer diagnosed in the third quarter of 2001 including descriptive analysis of pattern of surgical care and systemic treatment in early (FIGO I-IIA) and advanced (FIGO IIB-IV) ovarian cancer and both univariate and multivariate analysis of prognostic factors.
  • Standard care according to German guidelines was provided to only 35.5% of patients with early ovarian cancer.
  • Recommended chemotherapy was given to 78% in advanced disease.
  • Multivariate analysis showed advanced stage, poor performance status, comorbidity, ascites, and treatment in an institution not participating in cooperative studies to be associated with inferior survival.
  • Hospital volume did not affect treatment outcome.
  • Adherence to treatment guidelines showed remarkable variety among German hospitals, indicating options and need for improvement.
  • [MeSH-major] Guideline Adherence. Outcome Assessment (Health Care). Ovarian Neoplasms / drug therapy. Practice Guidelines as Topic. Quality of Health Care

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  • (PMID = 15823098.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 31
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9. Plisiecka-Hałasa J, Karpińska G, Szymańska T, Ziółkowska I, Madry R, Timorek A, Debniak J, Ułańska M, Jedryka M, Chudecka-Głaz A, Klimek M, Rembiszewska A, Kraszewska E, Dybowski B, Markowska J, Emerich J, Płuzańska A, Goluda M, Rzepka-Górska I, Urbański K, Zieliński J, Stelmachów J, Chrabowska M, Kupryjańczyk J: P21WAF1, P27KIP1, TP53 and C-MYC analysis in 204 ovarian carcinomas treated with platinum-based regimens. Ann Oncol; 2003 Jul;14(7):1078-85
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  • [Title] P21WAF1, P27KIP1, TP53 and C-MYC analysis in 204 ovarian carcinomas treated with platinum-based regimens.
  • BACKGROUND: The prognostic and predictive value of cell cycle regulatory proteins in ovarian cancer has not been established.
  • We evaluated the clinical and biological significance of P21(WAF1), P27(KIP1), C-MYC, TP53 and Ki67 expressions in ovarian cancer patients.
  • MATERIALS AND METHODS: Immunohistochemical analysis was performed on 204 ovarian carcinomas of International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IV treated with platinum-based chemotherapy.
  • CONCLUSIONS: We have shown an independent predictive value of P21(WAF1) LI in ovarian carcinoma patients.
  • A high frequency of C-MYC overexpression in endometrioid and clear cell carcinomas may suggest its role in the development of these tumor types.

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  • (PMID = 12853350.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / CDKN1A protein, human; 0 / Cell Cycle Proteins; 0 / Cyclin-Dependent Kinase Inhibitor p21; 0 / Cyclins; 0 / Enzyme Inhibitors; 0 / MYC protein, human; 0 / Proto-Oncogene Proteins c-myc; 0 / Tumor Suppressor Protein p53; 0 / Tumor Suppressor Proteins; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27; EC 2.7.11.22 / Cyclin-Dependent Kinases
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10. Joly F, Héron JF, Kerbrat P, Chauvergne J, Rios M, Mayer F, Chinet-Charrot P, Goupil A, Lebrun-Jezekova D, Vennin D, Lhommé C, Macé-Lesec'h J, Crouet H: High-dose platinum versus standard dose in advanced ovarian carcinoma: a randomized trial from the Gynecologic Cooperative Group of the French Comprehensive Cancer Centers (FNCLCC). Gynecol Oncol; 2000 Sep;78(3 Pt 1):361-8
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  • [Title] High-dose platinum versus standard dose in advanced ovarian carcinoma: a randomized trial from the Gynecologic Cooperative Group of the French Comprehensive Cancer Centers (FNCLCC).
  • OBJECTIVE: The aim of this study was to evaluate the impact of platinum dose intensity on pathological response rate and overall survival in patients with advanced ovarian adenocarcinoma.
  • METHODS: Between February 1992 and December 1996, 195 previously untreated patients with FIGO stage IIb-c, IIIb-c, or IV with macroscopic residual disease after suboptimal debulking surgery were randomized to receive CCC (100 mg/m(2) of cisplatin, 300 mg/m(2) of cyclophosphamide, 300 mg/m(2) of carboplatin, n = 96) or CC (100 mg/m(2) of cisplatin, 600 mg/m(2) of cyclophosphamide, n = 99) for six courses at 28-day intervals.
  • A second-look laparotomy was planned at the end of chemotherapy.
  • With a median follow-up of 53 months, the median time to failure and the 3-year treatment failure-free survival rate were 17.4 months and 22% vs 13 months and 11% in the two arms, respectively (P = 0.01).
  • The median survival time and the 3-year overall survival rate were, respectively, 30 months and 42% vs 25 months and 33% (P < 0.20).
  • CONCLUSION: The platinum dose intensification (1.6-fold increase) obtained with the CCC association improves the treatment failure-free survival without significant impact on overall survival when compared with the CC regimen in suboptimal debulked ovarian adenocarcinoma.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Carboplatin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Dose-Response Relationship, Drug. Female. Humans. Middle Aged. Neoplasm Staging. Survival Analysis

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  • [Copyright] Copyright 2000 Academic Press.
  • (PMID = 10985895.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; CCC protocol; CP protocol
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11. Mandić A, Nincić D, Vujkov T: [Ovarian epithelial carcinoma--a malignant disease sparing no age group]. Med Pregl; 2003 Mar-Apr;56(3-4):157-61
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  • [Title] [Ovarian epithelial carcinoma--a malignant disease sparing no age group].
  • INTRODUCTION: Ovarian epithelial carcinoma is one of the most common gynecologic malignancies and the fifth most frequent cause of cancer death in women.
  • Ovarian cancer affects women 65 years of age and older more frequently than younger women.
  • MATERIAL AND METHODS: Four young patients with ovarian epithelial carcinoma were treated at the Institute of Oncology in Sremska Kamenica, Serbia and Montenegro, in the period 1981-2000.
  • The stage of the disease was established using International Federation of Gynecology-Obstetrics (FIGO) Calssification.
  • Spread of the disease dictated the extent of operation and post-operative chemotherapy.
  • RESULTS: The first two patients underwent unilateral adnexectomy as initial treatment.
  • Final histopathological examination revealed an epithelial ovarian carcinoma, stage IIIa and IIb.
  • Total hysterectomy with unilateral adnexectomy and total omentectomy were performed in both patients as second treatment with chemotherapy, according to the Cisplatin/Carboplatin and Cyclophos-phamide (CP) protocol following surgery.
  • Another two patients underwent total hysterectomy with bilateral adnexectomy and total omentectomy as initial treatment with chemotherapy, CP protocol, following surgery.
  • Both patients had stage IIc.
  • Despite treatment, in two patients with stage IIIa and IIc, metastases were diagnosed.
  • DISCUSSION: Ovarian carcinomas are difficult to diagnose at early stage.
  • Histologic confirmation of the diagnosis, surgical staging, and aggressive surgical debulking, when possible, are all part of the initial evaluation and treatment.
  • In most cases, surgery is followed by chemotherapy.
  • Our study included 4 patients, medium age 17.3, with epithelial ovarian carcinoma which warns us to think twice when we get an adolescent patient with an adnexal mass.
  • CONCLUSION: Advancing age, the major risk factor for development of ovarian carcinoma is, of course, unalterable.
  • We investigated 4 patients medium age 17.3 years, with epithelial ovarian carcinoma.
  • [MeSH-major] Cystadenocarcinoma. Ovarian Neoplasms

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  • (PMID = 12899081.001).
  • [ISSN] 0025-8105
  • [Journal-full-title] Medicinski pregled
  • [ISO-abbreviation] Med. Pregl.
  • [Language] hrv
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Yugoslavia
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12. Do VT, Thomas GM, Bjarnason GA: Postoperative concurrent chronomodulated 5-fluorouracil/leucovorin infusion and pelvic radiotherapy for squamous cell carcinoma of the ovary arising from mature cystic teratoma. Int J Gynecol Cancer; 2001 Sep-Oct;11(5):418-21
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  • [Title] Postoperative concurrent chronomodulated 5-fluorouracil/leucovorin infusion and pelvic radiotherapy for squamous cell carcinoma of the ovary arising from mature cystic teratoma.
  • Primary squamous cell carcinoma (SCC) of the ovary arising from mature cystic teratoma (MCT) is rare.
  • Although different postoperative treatments have been tried, none appears to have influenced outcomes.
  • A 44-year-old patient with FIGO stage IIB SCC of the ovary arising in MCT had exploratory laparotomy and left salpingo-oophorectomy, leaving macroscopic residual pelvic disease.
  • Postoperative treatment consisted of a continuous concurrent chronomodulated infusion of 5-fluorouracil 150 mg/m2/day and leucovorin 10 mg/m2/day with 5 weeks of pelvic radiotherapy.
  • Given this patient's unusually long disease-free survival and the efficacy of concurrent chemotherapy and radiotherapy in other SCCs, the concurrent circadian treatment approach used for this patient should be explored in other cases of SCC of the ovary.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Ovarian Neoplasms / drug therapy. Pelvic Neoplasms / drug therapy. Teratoma / drug therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Ovariectomy. Postoperative Care

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  • (PMID = 11737476.001).
  • [ISSN] 1048-891X
  • [Journal-full-title] International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
  • [ISO-abbreviation] Int. J. Gynecol. Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] United States
  • [Chemical-registry-number] Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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13. Kupryjańczyk J, Madry R, Plisiecka-Hałasa J, Bar J, Kraszewska E, Ziółkowska I, Timorek A, Stelmachów J, Emerich J, Jedryka M, Płuzańska A, Rzepka-Górska I, Urbański K, Zieliński J, Markowska J: TP53 status determines clinical significance of ERBB2 expression in ovarian cancer. Br J Cancer; 2004 Nov 29;91(11):1916-23
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  • [Title] TP53 status determines clinical significance of ERBB2 expression in ovarian cancer.
  • ERBB2 expression has been found in 19 to 44% of ovarian carcinomas; however, its predictive value has not been demonstrated, and trastuzumab has not found clinical application in ovarian cancer patients.
  • We evaluated clinical significance of ERBB2 expression in relation to TP53 accumulation in ovarian carcinoma patients treated with platinum-based regimens.
  • Immunohistochemical analysis with CB11 and a novel NCL-CBE356 antibody (against the internal and external domains of ERBB2, respectively) was performed on 233 tumours (FIGO stage IIB-IV); the US Food and Drug Administration-approved grading system with 0 to 3+ scale was used for evaluation, and the results were analysed by the Cox and logistic regression models.
  • Our results may suggest that trastuzumab should be given postoperatively to patients with TP53(-)/ERBB2(+) ovarian carcinomas to enhance PS, and after completion of chemotherapy to patients with complete remission and TP53(+)/ERBB2(+) carcinomas to extend DFS time (in total to 30.4% of all patients analysed).
  • Thus, novel criteria for ovarian cancer patient inclusion for clinical trials with trastuzumab should be considered and tested.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / metabolism. Receptor, ErbB-2 / metabolism. Tumor Suppressor Protein p53 / metabolism

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  • (PMID = 15545967.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Epitopes; 0 / Organoplatinum Compounds; 0 / Tumor Suppressor Protein p53; EC 2.7.10.1 / Receptor, ErbB-2
  • [Other-IDs] NLM/ PMC2409772
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14. Wu Q, Suo Z, Kristensen GB, Baekelandt M, Nesland JM: The prognostic impact of EphB2/B4 expression on patients with advanced ovarian carcinoma. Gynecol Oncol; 2006 Jul;102(1):15-21
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  • [Title] The prognostic impact of EphB2/B4 expression on patients with advanced ovarian carcinoma.
  • OBJECTIVES: To analyze expressions of the EphB2 and EphB4 receptors in ovarian carcinomas and explore their clinicopathological correlations and prognostic value.
  • METHODS: 115 patients with advanced ovarian carcinoma FIGO IIB to IV were involved.
  • RESULTS: Ovarian carcinoma patients with age elder than 60 years had higher EphB2 expression than younger patients.
  • Expression of EphB2 and EphB4 protein did not significantly correlate with any other clinical variables, including FIGO stage, residual tumor, histological type and differentiation grade.
  • It was found that patients with strong immunostaining for EphB2 (P = 0.03) or EphB4 (P = 0.003) receptors had poorer survival, and patients with strong immunostaining for EphB4 receptor showed poorer response to chemotherapy (P = 0.036).
  • CONCLUSIONS: These studies suggest that EphB2 and B4 receptors are of prognostic value and EphB4 receptor may be an independent predictor of chemotherapy response in ovarian cancer patients.
  • [MeSH-major] Ovarian Neoplasms / enzymology. Receptor, EphB2 / biosynthesis. Receptor, EphB4 / biosynthesis

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  • (PMID = 16499955.001).
  • [ISSN] 0090-8258
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / RNA, Messenger; EC 2.7.10.1 / Receptor, EphB2; EC 2.7.10.1 / Receptor, EphB4
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15. Kupryjanczyk J, Kraszewska E, Ziolkowska-Seta I, Madry R, Timorek A, Markowska J, Stelmachow J, Bidzinski M, Polish Ovarian Cancer Study Group (POCSG): TP53 status and taxane-platinum versus platinum-based therapy in ovarian cancer patients: a non-randomized retrospective study. BMC Cancer; 2008;8:27
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  • [Title] TP53 status and taxane-platinum versus platinum-based therapy in ovarian cancer patients: a non-randomized retrospective study.
  • BACKGROUND: Taxane-platinum therapy (TP) has replaced platinum-based therapy (PC or PAC, DNA damaging chemotherapy) in the postoperative treatment of ovarian cancer patients; however, it is not always effective.
  • METHODS: We compared the effectiveness of PC/PAC (n = 253) and TP (n = 199) with respect to tumor TP53 accumulation in ovarian cancer patients with FIGO stage IIB-IV disease; this was a non-randomized retrospective study.
  • RESULTS: The advantage of taxane-platinum therapy over platinum-based therapy was seen in the TP53(+), and not in the TP53(-) group.
  • In the TP53(+) group taxane-platinum therapy enhanced the probability of complete remission (p = .018), platinum sensitivity (p = .014), platinum highly sensitive response (p = .038) and longer survival (OS, p = .008).
  • Poor tumor differentiation diminished the advantage from taxane-platinum therapy in the TP53(+) group.
  • In the TP53(-) group PC/PAC was at least equally efficient as taxane-platinum therapy and it enhanced the chance of platinum highly sensitive response (p = .010).
  • However, in the TP53(-) group taxane-platinum therapy possibly diminished the risk of death in patients over 53 yrs (p = .077).
  • Among factors that positively interacted with taxane-platinum therapy in some analyses were endometrioid and clear cell type, FIGO III stage, bulky residual tumor, more advanced age of patient and moderate tumor differentiation.
  • CONCLUSION: Our results suggest that taxane-platinum therapy is particularly justified in patients with TP53(+) tumors or older than 53 years.
  • In the group of patients < or =53 yrs and with TP53(-) tumors platinum-based therapy is possibly equally efficient.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / genetics. Tumor Suppressor Protein p53 / metabolism
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Cisplatin / administration & dosage. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Drug Resistance, Neoplasm / genetics. Female. Humans. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage. Retrospective Studies. Survival Analysis. Taxoids / administration & dosage. Treatment Outcome

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  • (PMID = 18230133.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / TP53 protein, human; 0 / Taxoids; 0 / Tumor Suppressor Protein p53; 15H5577CQD / docetaxel; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2268700
  • [Investigator] Debniak J; Emerich J; Jedryka M; Goluda M; Ulanska M; Pluzanska A; Klimek M; Urbanski K; Chudecka-Glaz A; Rzepka-Gorska I; Sobiczewski P; Derlatka P; Panek G; Spiewankiewicz B; Sawicki W
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16. Kupryjańczyk J, Szymańska T, Madry R, Timorek A, Stelmachów J, Karpińska G, Rembiszewska A, Ziółkowska I, Kraszewska E, Debniak J, Emerich J, Ułańska M, Płuzańska A, Jedryka M, Goluda M, Chudecka-Głaz A, Rzepka-Górska I, Klimek M, Urbański K, Breborowicz J, Zieliński J, Markowska J: Evaluation of clinical significance of TP53, BCL-2, BAX and MEK1 expression in 229 ovarian carcinomas treated with platinum-based regimen. Br J Cancer; 2003 Mar 24;88(6):848-54
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  • [Title] Evaluation of clinical significance of TP53, BCL-2, BAX and MEK1 expression in 229 ovarian carcinomas treated with platinum-based regimen.
  • In cell line studies, BCL-2, BAX, as well as novel MEK1 protein levels have strong influence on ovarian cancer response to cisplatin-based chemotherapy.
  • Immunohistochemical analysis was performed on 229 ovarian carcinomas FIGO stage IIB-IV treated with platinum-based chemotherapy; the results were analysed by the Cox and logistic regression models.
  • Clinical parameters (residual tumour size, patient age, FIGO stage) were the only indicators of overall survival (OS) and the strongest predictors of complete remission (CR).
  • On the other hand, BAX expression was the strongest (P=0.005) or the only (in FIGO IIIC, P=0.02) prognostic indicator of disease-free survival (DFS) in the TP53(+) group.
  • TP53(+) and TP53(-) ovarian carcinomas differed in clinical and molecular prognostic and predictive factors.
  • High MEK1 expression was associated with endometrioid and clear cell carcinomas (P=0.049); its loss was found with advancing FIGO stage (P=0.002).
  • Our results suggest that binomial TP53 status divides ovarian carcinomas into two biologically distinct groups.
  • BCL-2 and BAX, but not MEK1 expressions have predictive value in ovarian cancer patients treated with platinum-based chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Gene Expression Regulation, Neoplastic. Mitogen-Activated Protein Kinase Kinases / biosynthesis. Ovarian Neoplasms / drug therapy. Ovarian Neoplasms / genetics. Protein-Serine-Threonine Kinases / biosynthesis. Proto-Oncogene Proteins / biosynthesis. Proto-Oncogene Proteins c-bcl-2 / biosynthesis. Tumor Suppressor Protein p53 / biosynthesis
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Disease-Free Survival. Female. Humans. Immunohistochemistry. MAP Kinase Kinase 1. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Prognosis. Regression Analysis. Treatment Outcome. bcl-2-Associated X Protein

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  • (PMID = 12644821.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / BAX protein, human; 0 / Biomarkers, Tumor; 0 / Proto-Oncogene Proteins; 0 / Proto-Oncogene Proteins c-bcl-2; 0 / Tumor Suppressor Protein p53; 0 / bcl-2-Associated X Protein; EC 2.7.1.- / MAP2K1 protein, human; EC 2.7.11.1 / Protein-Serine-Threonine Kinases; EC 2.7.12.2 / MAP Kinase Kinase 1; EC 2.7.12.2 / Mitogen-Activated Protein Kinase Kinases; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2377076
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17. du Bois A, Rochon J, Lamparter C, Pfisterer J: [The Quality Assurance Program of the AGO Organkommission OVAR (QS-OVAR): Pattern of Care and Reality in Germany 2001]. Zentralbl Gynakol; 2005 Feb;127(1):9-17
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To evaluate pattern and quality of care for ovarian cancer in Germany and analyze adherence to treatment guidelines as well as prognostic factors for survival.
  • METHODS: Nationwide survey including patients with histological proven invasive epithelial ovarian cancer diagnosed in the third quarter 2001 including descriptive analysis of pattern of surgical care and systemic treatment in early (FIGO I-IIA) and advanced (FIGO IIB-IV) ovarian cancer and both univariate and multivariate analysis of prognostic factors.
  • Standard care according to German guidelines was provided to only 35.5 % of patients with early ovarian cancer.
  • Optimal debulking was reported for 61.4 % patients with FIGO stages IIB-IV.
  • Recommended platinum-paclitaxel chemotherapy was given to 3 out of 4 patients in advanced disease.
  • Multivariate analysis showed advanced stage, poor performance status, co-morbidity, ascites, postoperative tumor residuals, and less than standard care to be associated with inferior survival.
  • CONCLUSIONS: Adherence to treatment guidelines showed remarkable variety among German hospitals indicating options and need for improvement.
  • [MeSH-major] Delivery of Health Care / standards. Ovarian Neoplasms / therapy

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  • (PMID = 15702446.001).
  • [ISSN] 0044-4197
  • [Journal-full-title] Zentralblatt für Gynäkologie
  • [ISO-abbreviation] Zentralbl Gynakol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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18. Kornovski Y, Gorchev G: Histopathological findings in postoperative specimens in cervical cancer patients with stages IB2-IVA after neoadjuvant chemotherapy and preoperative plus postoperative radiotherapy. J BUON; 2007 Jan-Mar;12(1):57-63
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  • [Title] Histopathological findings in postoperative specimens in cervical cancer patients with stages IB2-IVA after neoadjuvant chemotherapy and preoperative plus postoperative radiotherapy.
  • PURPOSE: To determine the incidence of the histopathological findings indicative for risk of recurrence in patients with locally advanced cervical cancer (LACC) who were treated with neoadjuvant chemotherapy (NCT) and radiation therapy (RT) before operation.
  • PATIENTS AND METHODS: Sixty-three patients were included: 45 patients (group 1) underwent external beam RT and then surgical treatment followed by postoperative RT, and 18 (group 2) patients were treated with NCT and surgery followed by postoperative RT.
  • In group 1 FIGO stage IIB prevailed (n=29, 64.4%).
  • Forty-four (97.8%) patients had squamous cell carcinoma and 1 (5.6%) adenosquamous carcinoma.
  • In group 2 stage IIB also prevailed (n=13, 72.2%), whereas all 18 (100%) patients had squamous cell carcinoma.
  • RESULTS: In group 1 lymph node metastases (LNM) were found in 35.56% of the cases, macroscopically detectable LNM in 15.6%, LNM above the common iliac artery level in 11.1%, multiple LNM (>3 LNM) in 17.8%, parametrial invasion in 4.4%, deep stromal invasion in 31.1%, lymphovascular space invasion (LVSI) in 13.3%, infiltration of canalis cervicalis in 15.6%, infiltration of isthmus uteri in 8.9% and ovarian metastases in 4.4%.
  • In group 2 LNM were found in 38.89% of the patients, macroscopically detectable metastases in 22%, multiple (>3 LNM) LNM in 17%, LNM above the common iliac artery level in 22%, deep stromal invasion in 47%, parametrial infiltration in 24%, LVSI in 12%, tumor infiltration in canalis cervicalis in 12%, and ovarian metastases in 6%.
  • CONCLUSION: NCT followed by surgical treatment and RT leads to postoperative histological results that are not worse than the standard preoperative RT approach.
  • [MeSH-major] Carcinoma, Adenosquamous / pathology. Carcinoma, Adenosquamous / therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Uterine Cervical Neoplasms / pathology. Uterine Cervical Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Bulgaria / epidemiology. Chemotherapy, Adjuvant. Female. Follow-Up Studies. Humans. Hysterectomy. Incidence. Lymph Node Excision. Lymphatic Metastasis. Middle Aged. Neoadjuvant Therapy. Neoplasm Invasiveness. Neoplasm Staging. Prospective Studies. Radiotherapy, Adjuvant. Retrospective Studies. Time Factors. Treatment Outcome


19. Fedders M, Hartmann M, Schneider A, Kath R, Camara O, Oelschläger H: Markov-modeling for the administration of platinum analogues and paclitaxel as first-line chemotherapy as well as topotecan and liposomal doxorubicin as second-line chemotherapy with epithelial ovarian carcinoma. J Cancer Res Clin Oncol; 2007 Sep;133(9):619-25
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  • [Title] Markov-modeling for the administration of platinum analogues and paclitaxel as first-line chemotherapy as well as topotecan and liposomal doxorubicin as second-line chemotherapy with epithelial ovarian carcinoma.
  • PURPOSE: So far there is no analysis available on the cost effectiveness of the paclitaxel/platinum-analogue combination versus carboplatin monotherapy with ovarian cancer.
  • Up-to-now only a cost-utility analysis on ovarian carcinoma has been published (Ortega et al. in Gynecol Oncol 66(3):454-463, 1997), which in addition to the first-line chemotherapy included second-line chemotherapy with effectiveness and cost data in the analysis.
  • Therefore, within the scope of our study the cost effectiveness of platinum analogues and paclitaxel as first-line chemotherapy as well as topotecan and liposomal doxorubicin as second-lie chemotherapy was to be determined with epithelial ovarian carcinoma.
  • METHODS: For this purpose a decision-making Markov model was developed which represents the medical and economic consequences of the administration of paclitaxel and platinum derivatives in first-line chemotherapy and the administration of topotecan and liposomal doxorubicin in second-line chemotherapy in the treatment of epithelial ovarian carcinoma by means of data from the literature.
  • Patients were treated either in the early (FIGO stage I-IIa) or advanced stage (FIGO stage IIb-IV).
  • RESULTS: The therapeutic strategy caboplatin followed by topotecan costs 20,123.91 euros, the therapeutic strategy carboplatin followed by liposomal doxorubicin 22,336.57 euros, the therapeutic strategy carboplatin/pactlitaxel followed by liposomal topotecan 29,820.64 euros and the therapeutic strategy carboplatin/paclitaxel followed by liposomal doxorubicin 31,560.47 euros from the time of diagnosis until death or survival within 5 years.
  • CONCLUSIONS: Based on the threshold value of social willingness to pay 45,500 euros per year of life saved, the therapeutic strategy carboplatin followed by topotecan, the therapeutic strategy carboplatin followed by liposomal doxorubicin, the therapeutic strategy carboplatin/paclitaxel followed by topotcan and the therapeutic strategy carboplatin/paclitaxel followed by liposomal doxorubicin can be evaluated to be cost effective.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / economics. Neoplasms, Glandular and Epithelial / economics. Ovarian Neoplasms / economics

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  • [ErratumIn] J Cancer Res Clin Oncol. 2007 Dec;133(12):1025
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  • (PMID = 17458562.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Platinum Compounds; 7M7YKX2N15 / Topotecan; 80168379AG / Doxorubicin; P88XT4IS4D / Paclitaxel
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20. Kamura T, Jeon JD: Lymph node metastasis in a gynecologic malignancy. Yonsei Med J; 2002 Dec;43(6):783-91
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  • A radical hysterectomy was performed on patients with stage IA2 to IIB cervical cancer.
  • For these patients, many histopathological parameters have been reported to be prognostic factors of cervical cancer, such as a pelvic lymph node (PLN) metastasis, the histological subtype, the tumor diameter, the depth of the stromal invasion, a lymph-vascular space invasion (LVSI), a parametrial invasion, a corpus invasion and a vaginal invasion.
  • Ovarian cancer is normally treated with cytoreductive surgery followed by chemotherapy.
  • Although physicians have paid a great deal of attention to intraperitoneal disease, a substantial number of ovarian cancers have reported to involve the retroperitoneal lymph nodes.
  • Therefore, a lymph node metastasis has been introduced into FIGO staging.
  • In order to determine the possibility of individualizing a pelvic lymph node (PLN) dissection in patients with endometrial cancer, the relationship between PLN metastasis and the various prognostic factors was investigated.
  • In this paper, various prognostic variables including a lymph node metastasis were analyzed in cervical cancer, endometrial cancer, and ovarian cancer.
  • [MeSH-minor] Endometrial Neoplasms / pathology. Female. Humans. Lymphatic Metastasis. Ovarian Neoplasms / pathology. Uterine Cervical Neoplasms / pathology

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  • (PMID = 12497663.001).
  • [ISSN] 0513-5796
  • [Journal-full-title] Yonsei medical journal
  • [ISO-abbreviation] Yonsei Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
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