Advanced ovarian cancer: criteria of resectability

Bulletin du cancer
E ChereauE Daraï

Abstract

Residual disease is the first predictive factor for survival in women with ovarian cancer. Neoadjuvant chemotherapy still has not proved superiority in terms of overall survival compared with complete initial resection. Hence, initial surgery remains the cornerstone of management for patients with advanced ovarian cancer. Various parameters have been proposed to evaluate the ability of complete resection. Clinical evaluation of peritoneal carcinomatosis and ascite is not relevant enough while general status (ASA score) is correlated with the risk of postoperative complications. Preoperative dosage of CA-125 higher than 500 UI/L seems to be related with an increase risk of sub-optimal surgery. Recently, some authors challenged its prognostic value. For a CA-125 threshold at 500 UI/L, sensitivity, specificity, positive and negative predictive values range from 58 to 78%, 64 to 89%, 64 to 84% and 35.7 to 85.4%, respectively. Imaging criteria failed to report concordant results. Indeed, sensitivity, specificity, positive and negative predictive values vary from 52 to 100%, 75 to 100%, 49% to 100% and 50 to 100%, respectively. High-correlation has been demonstrated for carcinomatosis scores evaluating the dissemination of the diseas...Continue Reading

Citations

Mar 21, 2012·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Cecilia MidullaEmanuela Anastasi
Apr 18, 2014·Journal of Ovarian Research·Laetitia PicaudGwenael Ferron

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