In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .
OCEANS: A randomized, double-blinded, placebo-controlled phase III trial of chemotherapy with or without bevacizumab (BEV) in patients with platinum-sensitive recurrent epithelial ovarian (EOC), primary peritoneal (PPC), or fallopian tube cancer (FTC).
LBA5007 Background : BEV , a humanized anti-VEGF monoclonal antibody , has shown a progression-free survival ( PFS ) benefit in 2 frontline phase III trials in patients with EOC , PPC and FTC . The therapeutic impact of BEV in combination with carboplatin ( C ) and gemcitabine ( G ) followed by single agent BEV to disease progression ( PD ) was evaluated in this phase III trial in the platinum-sensitive recurrent setting . METHODS Patients had recurrent , platinum-sensitive EOC , PPC or FTC , 1 prior regimen , no prior BEV , ECOG performance status 0 - 1 , measurable disease . Subjects were r and omized to : Arm A : [ IV C ( AUC 4 , Day ( D ) 1 ) + G ( 1,000 mg/m2 D1 and 8) + placebo ( PL ) D1 ] q21D x 6 cycles ( c ) → PL q21D until PD or unacceptable toxicity ( tox ) Arm B : [ CG + BEV ( 15 mg/kg ) D1 ] q21D x 6 c → BEV q21D until PD or tox primary endpoint was investigator assessed PFS ( RECIST ) . Secondary endpoints included objective response ( OR ) , overall survival ( OS ) , duration of response and safety . The design provided 80 % power to detect a 27 % reduction in the hazard of progression or death in Arm B vs A , limiting the overall type I error of 5 % . RESULTS OCEANS enrolled 484 patients ( 242 per arm ) from 4/07 - 1/10 , median follow up of 24 months . BEV plus CG followed by single agent BEV to PD significantly increased PFS compared to CG alone ( HR=0.484 , p<0.0001 ) . OR increased by 21 % ( p<0.0001 ) . OS data is immature with only 29 % of patients having had an event . The safety profile was consistent with other BEV trials . CONCLUSIONS Results show a statistically significant and clinical ly relevant benefit when bevacizumab is added to chemotherapy in patients with recurrent , platinum sensitive EOC , PPC , and FTC . This is the first phase III trial of an antiangiogenic to demonstrate a clinical benefit to these patients . [ Table : see text ]
In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10 - 30 % of all cases , and systematic limphadenectomy , necessary to be able to obtain an adequate surgical staging .
Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer .
Radiotherapy can be used to palliate symptoms .
In the present , there is not a st and ardized screening method .
Diagnosis in early stages means a better survival .
Radiotherapy can be indicated to palliate symptoms
INTRODUCTION Ovarian cancer ( OC ) is the third most common gynecologic malignancy worldwide .
Most of cases it is of epithelial origin .
At the present time there is not a st and ardized screening method , which makes difficult the early diagnosis .
The 5-year survival is 90 % for early stages , however most cases present at advanced stages , which have a 5-year survival of only 5 - 20 % .
GICOM collaborative group , under the auspice of different institutions , have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia .
Until now , laparoscopy for diagnostic-staging surgery is not well known as a recommended method .
In advanced stages , primary cytoreduction is recommended as initial treatment .