Neoadjuvant chemotherapy in advanced stage ovarian cancer
Journal Title: International Journal of Clinical Obstetrics and Gynaecology - Year 2018, Vol 2, Issue 6
Abstract
Background: Primary debulking surgery followed by platinum based chemotherapy was the standard therapy for advanced stage of ovarian cancer in the past. Primary debulking could be performed only in 30 to 60% of the patients with advanced ovarian cancer. In patients who had massive ascites, pleural effusion and large abdominal tumor, hence optimal primary debulking with gross residual disease less than 1 cm was difficult without Neoadjuvant chemotherapy (NACT). Hence present day guidelines suggest to give 3 – 4 cycles of Neoadjuvant chemotherapy to downstage the disease, which eventually helps the surgeon in obtaining optimal cytoreduction, which may transform into a prolonged disease free and overall survival. Aim: 1.To study the radiological response of advanced ovarian cancer by RECIST (Response Evaluation Criteria In Solid Tumors) criteria using CT scan 2.To Evaluate the correlation of CA 125, pre NACT an post NACT. 3.To study the chemotherapy related changes in histopathological evaluation. Materials and Methods: Patients diagnosed as Ca ovary stage III and IV underwent CT imaging and serum CA-125 estimation before and after NACT followed by interval debulking and adjuvant chemotherapy, Response to the Neoadjuvant chemotherapy will be analysed by RECIST criteria. During surgery intra op tumor size is observed and also presence of non- target lesions and documented. The specimen is then sent for histopathological examination to look for chemotherapy related changes. Results: The study was conducted on 34 patients of whom 31 patients had partial response, 1 patient had stable disease and 2 patient had progressive disease after NACT. CA-125 was estimated in these patients prior and after NACT and was found to have reduction in the values which was statistically significant of p value of <0.0001, with mean and standard deviation of pre-operative and post-operative CA-125 being 1808.38± 2205.27 and 111.38± 181.84 respectively. Conclusion: Our present study showed that NACT reduced the tumor burden and it allowed easier and complete surgical cytoreduction and also reduced surgical complications and treatment related deaths and morbidity. This study also showed that CA-125 is one of the best markers in epitheial ovarian cancer as it helps to assess the objective response to chemotherapy. It also helps to know the prognosis of the disease.
Authors and Affiliations
Dr. Vishwanath, Dr. Prasanna K Shetty, Dr. Mubeena Beegum
Keywords
Related Articles
- EP ID EP504933
- DOI -
- Views 155
- Downloads 0
Prevalence of urinary tract infection in antenatal period at tertiary care hospital in rural Bangalore
Urinary tract infections frequently affect pregnant mothers. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remain the m...
A clinical study of early onset pre-eclampsia v/s late onset pre-eclampsia
Introduction: Preeclampsia is a multi-system disorder of unknown etiology that is unique to human pregnancy and is characterized by abnormal vascular response to placentation associated with increased systematic vascular...
Measurement of serum cholesterol levels as a predictor of preterm delivery
Introduction: Pregnancy is considered as an unique and physiologically normal episode in a women’s life. All pregnancies are at risk, while most pregnancies are uneventful. About 15% of pregnant women may develop a poten...
Biochemical and hematological investigations in pregnancy induced hypertension
To compare the biochemical and haematological markers in pre¬ eclampsia and eclampsia patients with normal pregnancies. Standard antenatal follow up should be carried out for the early detection and prevention of PIH. Te...
Role of vitamin D in gestational diabetes mellitus
Objective: To find the association between Vitamin D deficiency and GDM. Methods: Prospective study included 50 women with GDM and 50 normoglycemic pregnant women. Serum Vitamin D level was estimated and correlation betw...