Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report

Aleksandra Obuchowska, Arkadiusz Standyło, Alicja Ozga, Justyna Wójcik, Karolina Obuchowska, Paweł Skorupski

DOI: http://dx.doi.org/10.12775/JEHS.2020.10.09.009

Abstract


Introduction: Ovarian cancer accounts only for 4.7% of female malignancies in Poland but has the worst prognosis among gynaecological neoplasms. Due to non-specific and scant symptoms the disease is diagnosed in nearly 70% of cases in stages III and IV (FIGO). The primary goal of surgical treatment is complete cytoreduction with no residual disease left after surgery involving hysterectomy, bilateral adnexectomy, omentectomy and removal of all metastatic foci from the peritoneum and abdominal organs. If it is not possible to achieve the complete cytoreduction, patients may be qualified for neoadjuvant chemotherapy (NACT) and surgery after achieving complete or partial remission.

Purpose: Description of NACT protocol used for the treatment of stage IIIC ovarian cancer. Comparison of treatment results of advanced ovarian cancer using NACT and primary debulking surgery (PDS).

Case report: A 58-year-old female patient was hospitalized with the diagnosis of the pelvic mass. Her predominant signs were abdominal pain on the right flank and flatulence. Laboratory tests and imaging studies indicated a high risk of metastatic ovarian cancer. Initial diagnosis was confirmed on the laparoscopy. Ovarian cancer matched stage IIIC with Fagotti score of 8 points. The inspection of the abdominal organs revealed tumors in both adnexa, miliary spread on the parietal peritoneum, the surface of the small intestine and the diaphragm and the thick infiltration of greater omentum. Multiple specimens for the pathology were collected and left adnexectomy was done. Due to the inability to achieve complete cytoreduction, the patient was qualified to NACT. Following 6 cycles of standard protocol paclitaxel and carboplatin chemotherapy, laparotomy with hysterectomy, bilateral adnexectomy and omentecomy was done. Residual disease was found only within greater omentum but complete cytoreduction was achieved. The patient was discharged in good condition.

Summary: Clinical data indicates that patients with advanced ovarian cancer treated with NACT and surgery have similar prognosis  to those treated by primary cytoreductive surgery. The advantages of NACT are reduced perioperative morbidity and mortality, lower  complication rate and shorter hospital stay. In the described patient, the implementation of the NACT protocol has resulted in complete surgical cytoreduction which is the main factor permitting prolongation of life expectancy in woman with advanced ovarian cancer.


Keywords


ovarian cancer; neoadjuvant chemotherapy; cytoreductive surgery; postoperative complications

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References


Wojciechowska U, Didkowska J. Zachorowania i zgony na nowotwory złośliwe w Polsce. [Incidence and deaths of malignant cancer in Poland]. Krajowy Rejestr Nowotworów, Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie – Państwowy Instytut Badawczy. Available at: http://onkologia.org.pl/raporty/, access of the day: 10/03/2020.

Kehoe S, Hook J, Nankivell M, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386(9990):249-57.

Lalwani N, Prasad S, Vikram R, Shanbhogue A, Huettner P, et al. Histologic, molecular, and cytogenetic features of ovarian cancers: implications for diagnosis and treatment. Radiographics 2011; 31: 625-646.

Fagotti A, Ferrandina G, Fanfani F, Garganese G, Vizzielli G, et al. Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma. Am J Obstet Gynecol 2008; 199:642.e1-642.e6.

Basta A, Bidziński M, Bieńkiewicz A, Blecharz P, Bodnar L, et al. Recommendations of the Polish Gynecological Oncology Society for the diagnosis and treatment of ovarian cancer. Gynecol Oncol 2017; 15(1), 5–23.

Geomini P, Kruitwagen R, Bremer GL et al. The accuracy of risk scores in predicting ovarian malignancy: a systematic review. Obstet Gynecol 2009; 113: 384–394.

Konstantinopoulos P, Ceccaldi R, Shapiro G, D'Andrea A. Homologous recombination deficiency: Exploiting the fundamental vulnerability of ovarian cancer. Cancer Discov 2015; 5(11): 1137–1154.

Kujawa K, Lisowska K. Ovarian cancer – from biology to clinic. Postepy Hig Med Dosw 2015; 69:1275-90.

Sehouli J, Savvatis K, Braicu E, Schmidt S, Lichtenegger W, et al. Primary Versus Interval Debulking Surgery in Advanced Ovarian Cancer: Results From a Systematic Single-Center Analysis. Int J Gynecol Cancer 2010; 20(8):1331-40.

Hoskins WJ, McGuire WP, Brady MF, et al. The effect of diameter of largest residual disease on survival after primary cytoreductive surgery in patients with suboptimal residual epithelial ovarian carcinoma. Am J Obstet Gynecol 1994; 170(4):974-980. doi:10.1016/s0002-9378(94)70090-7.

Hoskins WJ, Bundy BN, Thigpen JT, Omura GA. The Influence of Cytoreductive Surgery on Recurrence-Free Interval and Survival in Small-Volume Stage III Epithelial Ovarian Cancer: A Gynecologic Oncology Group Study. Gynecol Oncol 1992; 47: 159-166.

Elattar A, Bryant A, Winter-Roach B, et al. Optimal primary surgical treatment for advanced epithelial ovarian cancer. Cochrane Database Syst Rev 2011; (8):CD007565.

Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20(5):1248-1259. doi:10.1200/JCO.2002.20.5.1248.

Gerestein C, Damhuis R, Burgerc C, Kooi G. Postoperative mortality after primary cytoreductive surgery for advanced stage epithelial ovarian cancer: A systematic review. Gynaecologic Oncology 2009; 114(3):523-7.


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