Аспекты выбора первичного лечения больных распространенным раком яичников
https://doi.org/10.17650/1994-4098-2016-12-3-62-69
Аннотация
В статье рассмотрены вопросы выбора тактики лечения пациенток с диссеминированными формами рака яичников. Подробно оценена современная доказательная база, касающаяся преимуществ и недостатков выполнения хирургического лечения или неоадъювантной химиотерапии на 1-м этапе лечения в зависимости от функционального состояния больных и распространенности опухолевого процесса. Представлены данные литературы о частоте оптимальных циторедукций в различных странах мира и выживаемости больных в зависимости от размера остаточной опухоли после хирургического этапа лечения. Рассмотрена роль вы- полнения лимфодиссекции, а также комбинированных хирургических операций с резекцией тонкой и/или толстой кишки, печени, селезенки, брюшины и т.д. Проанализированы существующие факторы прогноза и прогностические модели, позволяющие выделить пациенток, которым на 1-м этапе лечения в силу низкой вероятности выполнения оптимальной циторедукции показано проведение неоадъювантной химиотерапии.
Об авторах
С. О. Никогосян
ФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России
Россия
Россия
гинекологическое отделение,
115478, Москва, Каширское шоссе, 23
В. В. Кузнецов
ФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России
Россия
Россия
гинекологическое отделение,
115478, Москва, Каширское шоссе, 23
А. З. Загаштоков
ФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России
Россия
Россия
гинекологическое отделение,
115478, Москва, Каширское шоссе, 23
А. А. Румянцев
ФГБУ «РОНЦ им. Н.Н. Блохина» Минздрава России
Россия
Россия
гинекологическое отделение,
115478, Москва, Каширское шоссе, 23
Список литературы
1. Badgwell D., Bast R.C. Jr. Early detection of ovarian cancer. Dis Markers 2007;23(5–6): 397–410. PMID: 18057523.
2. Torre L.A., Bray F., Siegel R.L. et al. Global cancer statistics, 2012. CA Cancer J Clin 2015;65(2):87–108. DOI: 10.3322/caac.21262. PMID: 25651787.
3. Eisenhauer E.L., Abu-Rustum N.R., Sonoda Y. et al. The addition of extensive upper abdominal surgery to achieve optimal cytoreduction improves survival in patients with stages IIIC–IV epithelial ovarian cancer. Gynecol Oncol 2006;103(3):1083–90. DOI: 10.1016/j.ygyno.2006.06.028. PMID: 16890277.
4. Ren Y., Jiang R., Yin S. et al. Radical surgery versus standard surgery for primary cytoreduction of bulky stage IIIC and IV ovarian cancer: an observational study. BMC Cancer 2015;15:583. DOI: 10.1186/s12885-015-1525-1. PMID: 26268818.
5. Griffiths C.T. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma. Natl Cancer Inst Monogr 1975;42:101–4. PMID: 1234624.
6. Bristow R.E., Tomacruz R.S., Armstrong D.K. et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002;20(5):1248–59. PMID: 11870167.
7. Chi D.S., Eisenhauer E.L., Lang J. et al. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006;103(2):559–64. DOI: 10.1016/j.ygyno.2006.03.051. PMID: 16714056.
8. Colombo P.E., Mourregot A., Fabbro M. et al. Aggressive surgical strategies in advanced ovarian cancer: a monocentric study of 203 stage IIIC and IV patients. Eur J Surg Oncol 2009;35(2):135–43. DOI: 10.1016/j.ejso.2008.01.005. PMID: 18289825.
9. Mangili G., Scambia G., Ottolina J. et al. Comparison of optimal cytoreduction rates in emergency versus non-emergency admissions for advanced ovarian cancer: a multi-institutional study. Eur J Surg Oncol 2013;39(8):906–11. DOI: 10.1016/j.ejso.2013.05.011. PMID: 23755990.
10. Marx C., Bendixen A., Hogdall C. et al. Organisation and quality of primary surgical intervention for ovarian cancer in Denmark. Acta Obstet Gynecol Scand 2007;86(12): 1496–502. DOI: 10.1080/00016340701622294. PMID: 17851818.
11. Hyman D.M., Long K.C., Tanner E.J. et al. Outcomes of primary surgical cytoreduction in patients with BRCA-associated highgrade serous ovarian carcinoma. Gynecol Oncol 2012;126(2):224–8. DOI: 10.1016/j.ygyno.2012.05.001. PMID: 22579790.
12. Chi D.S., Franklin C.C., Levine D.A. et al. Improved optimal cytoreduction rates for stages IIIC and IV epithelial ovarian, fallopian tube, and primary peritoneal cancer: a change in surgical approach. Gynecol Oncol 2004;94(3):650–4. DOI: 10.1016/j.ygyno.2004.01.029. PMID: 15350354.
13. Tanner E.J., Long K.C., Feffer J.B. et al. Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer. Gynecol Oncol 2013;128(1):28–33. DOI: 10.1016/j.ygyno.2012.09.019. PMID: 23017819.
14. Luyckx M., Leblanc E., Filleron T. et al. Maximal cytoreduction in patients with FIGO stage IIIC to stage IV ovarian, fallopian, and peritoneal cancer in day-to-day practice: a Retrospective French Multicentric Study. Int J Gynecol Cancer 2012;22(8):1337–43. DOI: 10.1097/IGC.0b013e31826a3559. PMID: 22964527.
15. Keyver-Paik M.D., Abramian A., Domrose C. et al. Integrated care in ovarian cancer “IgV Ovar”: results of a German pilot for higher quality in treatment of ovarian cancer. J Cancer Res Clin Oncol 2016;142(2):481–7. DOI: 10.1007/s00432-015-2055-6. PMID: 26498774.
16. Schmalfeldt B., Burges A., Mayr D. et al. Qualität der Therapie des Ovarialkarzinoms in der Region des Tumorzentrums München. Epidemiologische Daten im Vergleich. Geburtshilfe Frauenheilkd 2014;74:PO_Onko07_11.
17. Kehoe S., Hook J., Nankivell M. Chemotherapy or upfront surgery for newly diagnosed advanced ovarian cancer: results from the MRC CHORUS trial. Chicago: 2013 ASCO Annual Meeting. Abstract 5500.
18. Chi D.S., Eisenhauer E.L., Zivanovic O. et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 2009;114(1):26–31. DOI: 10.1016/j.ygyno.2009.03.018. PMID: 19395008.
19. Crawford S.C., Vasey P.A., Paul J. et al. Does aggressive surgery only benefit patients with less advanced ovarian cancer? Results from an international comparison within the SCOTROC-1 Trial. J Clin Oncol 2005;23(34):8802–11. DOI: 10.1200/JCO.2005.02.1287. PMID: 16314640.
20. Covens A.L. A critique of surgical cytoreduction in advanced ovarian cancer. Gynecol Oncol 2000;78(3 Pt 1):269–74. DOI: 10.1006/gyno.2000.5926. PMID: 10985879.
21. Horowitz N.S., Miller A., Rungruang B. et al. Does aggressive surgery improve outcomes? Interaction between preoperative disease burden and complex surgery in patients with advanced-stage ovarian cancer: an analysis of GOG 182. J Clin Oncol 2015;33(8):937–43. DOI: 10.1200/JCO.2014.56.3106. PMID: 25667285.
22. Chang S.J., Bristow R.E., Chi D.S., Cliby W.A. Role of aggressive surgical cytoreduction in advanced ovarian cancer. J Gynecol Oncol 2015;26(4):336–42. DOI: 10.3802/jgo.2015.26.4.336. PMID: 26197773.
23. Ang C., Chan K.K., Bryant A. et al. Ultraradical (extensive) surgery versus standard surgery for the primary cytoreduction of advanced epithelial ovarian cancer. Cochrane Database Syst Rev 2011;(4):CD007697. DOI: 10.1002/14651858.CD007697.pub2. PMID: 21491400.
24. Kang S., Jong Y.H., Hwang J.H. et al. Is neo-adjuvant chemotherapy a “waiver” of extensive upper abdominal surgery in advanced epithelial ovarian cancer? Ann Surg Oncol 2011;18(13):3824–7. DOI: 10.1245/s10434-011-1830-0. PMID: 21691879.
25. Nelson B.E., Rosenfield A.T., Schwartz P.E. Preoperative abdominopelvic computed tomographic prediction of optimal cytoreduction in epithelial ovarian carcinoma. J Clin Oncol 1993;11(1):166–72. PMID: 8418230.
26. Bristow R.E., Duska L.R., Lambrou N.C. et al. A model for predicting surgical outcome in patients with advanced ovarian carcinoma using computed tomography. Cancer 2000;89(7):1532–40. PMID: 11013368.
27. Axtell A.E., Lee M.H., Bristow R.E. et al. Multi-institutional reciprocal validation study of computed tomography predictors of suboptimal primary cytoreduction in patients with advanced ovarian cancer. J Clin Oncol 2007;25(4):384–9. DOI: 10.1200/JCO.2006.07.7800. PMID: 17264334.
28. Risum S., Hogdall C., Loft A. et al. Prediction of suboptimal primary cytoreduction in primary ovarian cancer with combined positron emission tomography/computed tomography – a prospective study. Gynecol Oncol 2008;108(2):265–70. DOI: 10.1016/j.ygyno.2007.11.002. PMID: 18055006.
29. Vorgias G., Iavazzo C., Savvopoulos P. et al. Can the preoperative Ca-125 level predict optimal cytoreduction in patients with advanced ovarian carcinoma? A single institution cohort study. Gynecol Oncol 2009;112(1): 11–5. PMID: 19119502.
30. Arits A.H., Stoot J.E., Botterweck A.A. et al. Preoperative serum CA125 levels do not predict suboptimal cytoreductive surgery in epithelial ovarian cancer. Int J Gynecol Cancer 2008;18(4):621–8. DOI: 10.1111/j.1525-1438.2007.01064.x. PMID: 17868339.
31. Janco J.M., Glaser G., Kim B. et al. Development of a prediction model for residual disease in newly diagnosed advanced ovarian cancer. Gynecol Oncol 2015;138(1):70–7. DOI: 10.1016/j.ygyno.2015.04.013. PMID: 25913130.
32. Suidan R.S., Ramirez P.T., Sarasohn D.M. et al. A multicenter prospective trial evaluating the ability of preoperative computed tomography scan and serum CA-125 to predict suboptimal cytoreduction at primary debulking surgery for advanced ovarian, fallopian tube, and peritoneal cancer. Gynecol Oncol 2014;134(3): 455–61. DOI: 10.1016/j.ygyno.2014.07.002. PMID: 25019568.
33. Gerestein C.G., Eijkemans M.J., Bakker J. et al. Nomogram for suboptimal cytoreduction at primary surgery for advanced stage ovarian cancer. Anticancer Res 2011;31(11):4043–9. PMID: 22110240.
34. Bonome T., Levine D.A., Shih J. et al. A gene signature predicting for survival in suboptimally debulked patients with ovarian cancer. Cancer Res 2008;68(13):5478–86. DOI: 10.1158/0008-5472.CAN-07-6595. PMID: 18593951.
35. Riester M., Wei W., Waldron L. et al. Risk prediction for late-stage ovarian cancer by meta-analysis of 1525 patient samples. J Natl Cancer Inst 2014;106(5). DOI: 10.1093/jnci/dju048. PMID: 24700803.
36. Liu Z., Beach J.A., Agadjanian H. et al. Suboptimal cytoreduction in ovarian carcinoma is associated with molecular pathways characteristic of increased stromal activation. Gynecol Oncol 2015;139(3):394–400. DOI: 10.1016/j.ygyno.2015.08.026. PMID: 26348314.
37. Berchuck A., Iversen E.S., Lancaster J.M. et al. Prediction of optimal versus suboptimal cytoreduction of advanced-stage serous ovarian cancer with the use of microarrays. Am J Obstet Gynecol 2004;190(4):910–25. DOI: 10.1016/j.ajog.2004.02.005. PMID: 15118612.
38. Borley J., Wilhelm-Benartzi C., Brown R., Ghaem-Maghami S. Does tumour biology determine surgical success in the treatment of epithelial ovarian cancer? A systematic literature review. Br J Cancer 2012;107(7): 1069–74. DOI: 10.1038/bjc.2012.376. PMID: 22935582.
39. Morrison J., Haldar K., Kehoe S., Lawrie T.A. Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer. Cochrane Database Syst Rev 2012;(8):CD005343. DOI: 10.1002/14651858.CD005343.pub3. PMID: 22895947.
40. van Meurs H.S., Tajik P., Hof M.H. et al. Which patients benefit most from primary surgery or neoadjuvant chemotherapy in stage IIIC or IV ovarian cancer? An exploratory analysis of the European Organisation for Research and Treatment of Cancer 55971 randomised trial. Eur J Cancer 2013;49(15):3191–201. DOI: 10.1016/j.ejca.2013.06.013. PMID: 23850170.
41. Siesto G., Cavina R., Romano F., Vitobello D. Primary debulking surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer: a propensity-matched analysis. Am J Clin Oncol 2016. DOI: 10.1097/COC.0000000000000262. PMID: 26757434.
42. Bristow R.E., Chang J., Ziogas A. et al. Impact of National Cancer Institute Comprehensive Cancer Centers on ovarian cancer treatment and survival. J Am Coll Surg 2015;220(5):940–50. DOI: 10.1016/j.jamcollsurg.2015.01.056. PMID: 25840536.
43. du Bois A., Reuss A., Pujade-Lauraine E. et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 2009;115(6): 1234–44. DOI: 10.1002/cncr.24149. PMID: 19189349.
44. Bristow R.E., Chang J., Ziogas A. et al. High-volume ovarian cancer care: survival impact and disparities in access for advanced-stage disease. Gynecol Oncol 2014;132(2):403–10. DOI: 10.1016/j.ygyno.2013.12.017. PMID: 24361578.
Рецензия
Для цитирования:
Никогосян С.О., Кузнецов В.В., Загаштоков А.З., Румянцев А.А. Аспекты выбора первичного лечения больных распространенным раком яичников. Опухоли женской репродуктивной системы. 2016;12(3):62-69. https://doi.org/10.17650/1994-4098-2016-12-3-62-69
For citation:
Nikogosyan S.O., Kuznetsov V.V., Zagashtokov A.Z., Rumyantsev A.A. Optimizing the primary treatment of patients with advanced ovarian cancer. Tumors of female reproductive system. 2016;12(3):62-69. (In Russ.) https://doi.org/10.17650/1994-4098-2016-12-3-62-69
Просмотров:
676
Послать статью по эл. почте 