Imperial College London
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DrJonathanKrell

Faculty of Medicine, Department of Surgery & Cancer

Clinical SL in Medical Oncology (Gynaecological Oncology)
 
 
 
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j.krell

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hall:2019:10.1245/s10434-019-07516-3,
author = {Hall, M and Savvatis, K and Nixon, K and Kyrgiou, M and Hariharan, K and Padwick, M and Owens, O and Cunnea, P and Campbell, J and Farthing, A and Stumpfle, R and Vazquez, I and Watson, N and Krell, J and Gabra, H and Rustin, G and Fotopoulou, C},
doi = {10.1245/s10434-019-07516-3},
journal = {Annals of Surgical Oncology},
pages = {2943--2951},
title = {Maximal-effort cytoreductive surgery for ovarian cancer patients with a high tumor burden: variations in practice and impact on outcome},
url = {http://dx.doi.org/10.1245/s10434-019-07516-3},
volume = {26},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThis study aimed to compare the outcomes of two distinct patient populations treated within two neighboring UK cancer centers (A and B) for advanced epithelial ovarian cancer (EOC).MethodsA retrospective analysis of all new stages 3 and 4 EOC patients treated between January 2013 and December 2014 was performed. The Mayo Clinic surgical complexity score (SCS) was applied. Cox regression analysis identified the impact of treatment methods on survival.ResultsThe study identified 249 patients (127 at center A and 122 in centre B) without significant differences in International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO 4, 29.7% at centers A and B), Eastern Cooperative Oncology Group (ECOG) performance status (ECOG < 2, 89.9% at centers A and B), or histology (serous type in 84.1% at centers A and B). The patients at center A were more likely to undergo surgery (87% vs 59.8%; p < 0.001). The types of chemotherapy and the patients receiving palliative treatment alone were equivalent between the two centers (3.6%). The median SCS was significantly higher at center A (9 vs 2; p < 0.001) with greater tumor burden (9 vs 6 abdominal fields involved; p < 0.001), longer median operation times (285 vs 155 min; p < 0.001), and longer hospital stays (9 vs 6 days; p < 0.001), but surgical morbidity and mortality were equivalent. The independent predictors of reduced overall survival (OS) were non-serous histology (hazard ratio [HR], 1.6; 95% confidence interval [CI] 1.04–2.61), ECOG higher than 2 (HR, 1.9; 95% CI 1.15–3.13), and palliation alone (HR, 3.43; 95% CI 1.51–7.81). Cytoreduction, of any timing, had an independent protective impact on OS compared with chemotherapy alone (HR, 0.31 for interval surgery and 0.39 for primary surgery), even after adjustment for other prognostic factors.ConclusionsIncorporating surgery into the initia
AU  - Hall,M
AU  - Savvatis,K
AU  - Nixon,K
AU  - Kyrgiou,M
AU  - Hariharan,K
AU  - Padwick,M
AU  - Owens,O
AU  - Cunnea,P
AU  - Campbell,J
AU  - Farthing,A
AU  - Stumpfle,R
AU  - Vazquez,I
AU  - Watson,N
AU  - Krell,J
AU  - Gabra,H
AU  - Rustin,G
AU  - Fotopoulou,C
DO  - 10.1245/s10434-019-07516-3
EP  - 2951
PY  - 2019///
SN  - 1068-9265
SP  - 2943
TI  - Maximal-effort cytoreductive surgery for ovarian cancer patients with a high tumor burden: variations in practice and impact on outcome
T2  - Annals of Surgical Oncology
UR  - http://dx.doi.org/10.1245/s10434-019-07516-3
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000478894200039&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/73036
VL  - 26
ER  -
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