Gynecologic

Systematic lymphadenectomy in ovarian cancer at second-look surgery: a randomised clinical trial.

Posted by

0


The role of systematic aortic and pelvic lymphadenectomy (SAPL) at second-look surgery in early stage or optimally debulked advanced ovarian cancer is unclear and never addressed by randomised studies.

Methods:

From January 1991 through May 2001, 308 patients with the International Federation of Gynaecology and Obstetrics stage IA–IV epithelial ovarian carcinoma were randomly assigned to undergo SAPL (n=158) or resection of bulky nodes only (n=150). Primary end point was overall survival (OS).

Results:

The median operating time, blood loss, percentage of patients requiring blood transfusions and hospital stay were higher in the SAPL than in the control arm (P<0.001). The median number of resected nodes and the percentage of women with nodal metastases were higher in the SAPL arm as well (44% vs 8%, P<0.001 and 24.2% vs 13.3%, P:0.02). After a median follow-up of 111 months, 171 events (i.e., recurrences or deaths) were observed, and 124 patients had died. Sites of first recurrences were similar in both arms. The adjusted risk for progression and death were not statistically different (hazard ratio (HR) for progression=1.18, 95% confidence interval (CI)=0.87–1.59; P=0.29; 5-year progression-free survival (PFS)=40.9% and 53.8%; HR for death=1.04, 95% CI=0.733–1.49; P=0.81; 5-year OS=63.5% and 67.4%, in the SAPL and in the control arm, respectively).

Conclusion:

SAPL in second-look surgery for advanced ovarian cancer did not improve PFS and OS.

Source: British journal of oncology

 

 

 

 

To Life (again) as a Two-Time Cancer Survivor.

Posted by

1


I’m walking a fine line between jubilation and anxiety. As a two-time ovarian cancer survivor, I’m nearing the anniversary of my recurrence. Although I feel fine, this type of cancer isn’t the most accommodating.

My nerves always manage to creep up on my dates with the ‘gists – in my case, the oncologist and gynecologist, which alternate every three to six months.  Following the tests, as I wait for the results, my mind never fails to think of family and friends… several who are also battling cancer now and a few who lost their fight.

My most recent visit this month was no different. I feel good physically but my mind was racing. My aunt who is battling a recurrence from lymphoma; my college friend Julie contending with pancreatic cancer; and Mary, a mom of three who is fighting to win the battle with breast cancer her sister lost. I also thought of a dear friend, Kelly, who passed away from ovarian cancer in 2010.

I wiped the tears from my eyes as I listened to the doctor review the results and then dictate a note into my chart. He said: “She presents back to the office today for routine cancer surveillance. It should be noted… years since her recurrence and remains clinically NED.” (NED is the acronym for “no evidence of disease.” It’s the clinical term for saying I’m fine.)

I left the office realizing how lucky I am. I can’t change the past but I do have a team of amazing physicians who are a part of the Mayo Clinic Cancer Center working daily to change the future of medicine. They are doing research and advancing treatments every day. And I – as a survivor – am a great example of their work.

Five years is a major milestone in the cancer world. It’s a date most cancer patients wonder if they’ll make. It’s a precious gift. Of time. Of comfort. Of hope.  Although the doctors are looking at my official five year marker as next year (commemorating the end of my active treatment ), I’m going to celebrate now. A massage, a pedicure and a glass of champagne. L’chaim!

Source: Mayo Clinic.