Artikel
Ovarian Cancer Treatment Reality in Northern Rheinland-Pfalz (Germany). Suboptimal surgical treatment as the cause for inferior survival. A Retrospective Study of 139 Patients Receiving Chemotherapy and Palliative Care in an Oncology Group Practice.
Suche in Medline nach
Autoren
Veröffentlicht: | 20. März 2006 |
---|
Gliederung
Text
Background: 9670 women are diagnosed with ovarian cancer each year in Germany. With regard to the incidence, ovarian cancer has the highest mortality of all gynecologic cancers. Highly significant prognostic factors are FIGO-Stage, the size of the postoperative tumorrest and the age of the patient.
Patients and methods: Treatment from 139 consecutive patients (pat) who were treated in our group practice between 1995-2003 was evaluated retrospectively.
Results: The median age was 61 years (18-84). FIGO-stage was distributed as follows: Stage I 15,8%, stage II 12,9%, stage III 53,2%, stage IV 16,5%. 138 pat received surgery and chemotherapy, 1 pat chemotherapy only. Surgical treatment was performed at a University hospital or a teaching hospital in 49 pat (35,5%). 89 pat (64,5%) were operated in a local or district hospital. R0-resection could be performed in only 15 patients (10,8%). The postoperative tumorrest was < 1cm in 50 pat (36%). 24 pat (17,3%) had a tumorrest > 1cm and 49 pat (35,5%) had a tumorrest above 2 cm. 93,3% of the pat received a postoperative, platinum based chemotherapy. Toxicity of chemotherapy was mild with only 11 (5,1%) hospital admissions that were therapy related. The median survival since first diagnosis was 42 months (1-346(+)). Median survival since the beginning of second line chemotherapy was 21 months (0-97(+)). The 5-year-survival rate of the whole cohort was only 28%. The main prognostic factors for survival were FIGO-stage, size of the postoperative tumorrest and patient age. 80 pat (57,6%) died, 45 (56,3%) at home and 33 (41,3%) in hospital.
Conclusions: Overall survival in epithelial ovarian cancer is significantly inferior in this patient cohort compared to the results of the last FIGO-report from 2003. The cause is the suboptimal surgical treatment with 52,8% of pat having a remaining postoperative tumorrest greater than 1 cm. Thus we have developed a standardized operation evaluation sheet that may be used to improve the surgical treatment in epithelial ovarian cancer in Germany.
This work was supported by Bristol-Myers Squibb