Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report
| Main Authors: | Obuchowska, Aleksandra, Standyło, Arkadiusz, Ozga, Alicja, Wójcik, Justyna, Obuchowska, Karolina, Skorupski, Paweł |
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| Format: | Article eJournal |
| Terbitan: |
, 2020
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| Online Access: |
https://zenodo.org/record/4014352 |
Daftar Isi:
- Obuchowska Aleksandra, Standyło Arkadiusz, Ozga Alicja, Wójcik Justyna, Obuchowska Karolina, Skorupski Paweł. Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report. Journal of Education, Health and Sport. 2020;10(9):84‐91. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.09.009 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.09.009 https://zenodo.org/record/4014352 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 10.08.2020. Revised: 15.08.2020. Accepted: 04.09.2020. Neoadjuvant chemotherapy for IIIC stage ovarian cancer - case report Aleksandra Obuchowska1a, Arkadiusz Standyło1b, Alicja Ozga1c, Justyna Wójcik1d, Karolina Obuchowska1e, Paweł Skorupski2f 1 Student Scientific Group at the 2nd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland 2 2nd Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland a aobuchowska12@gmail.com; https://orcid.org/0000-0003-0464-2695 b a.standylo@gmail.com; https://orcid.org/0000-0002-5154-4759 c aozga1@gmail.com; https://orcid.org/0000-0003-1291-905X d justynawojcik455@gmail.com; https://orcid.org/0000-0001-7163-6784 e karolinaobuchowska99@gmail.com; https://orcid.org/0000-0003-4519-8236 f pawskor@tlen.pl; https://orcid.org/0000-0002-1635-831X Abstract Introduction: Ovarian cancer accounts only for 4.7% of female malignancies in Poland but has the worst prognosis among gynaecological neoplasms. Due to non-specific and scant symptoms the disease is diagnosed in nearly 70% of cases in stages III and IV (FIGO). The primary goal of surgical treatment is complete cytoreduction with no residual disease left after surgery involving hysterectomy, bilateral adnexectomy, omentectomy and removal of all metastatic foci from the peritoneum and abdominal organs. If it is not possible to achieve the complete cytoreduction, patients may be qualified for neoadjuvant chemotherapy (NACT) and surgery after achieving complete or partial remission. Purpose: Description of NACT protocol used for the treatment of stage IIIC ovarian cancer. Comparison of treatment results of advanced ovarian cancer using NACT and primary debulking surgery (PDS). Case report: A 58-year-old female patient was hospitalized with the diagnosis of the pelvic mass. Her predominant signs were abdominal pain on the right flank and flatulence. Laboratory tests and imaging studies indicated a high risk of metastatic ovarian cancer. Initial diagnosis was confirmed on the laparoscopy. Ovarian cancer matched stage IIIC with Fagotti score of 8 points. The inspection of the abdominal organs revealed tumors in both adnexa, miliary spread on the parietal peritoneum, the surface of the small intestine and the diaphragm and the thick infiltration of greater omentum. Multiple specimens for the pathology were collected and left adnexectomy was done. Due to the inability to achieve complete cytoreduction, the patient was qualified to NACT. Following 6 cycles of standard protocol paclitaxel and carboplatin chemotherapy, laparotomy with hysterectomy, bilateral adnexectomy and omentecomy was done. Residual disease was found only within greater omentum but complete cytoreduction was achieved. The patient was discharged in good condition. Summary: Clinical data indicates that patients with advanced ovarian cancer treated with NACT and surgery have similar prognosis to those treated by primary cytoreductive surgery. The advantages of NACT are reduced perioperative morbidity and mortality, lower complication rate and shorter hospital stay. In the described patient, the implementation of the NACT protocol has resulted in complete surgical cytoreduction which is the main factor permitting prolongation of life expectancy in woman with advanced ovarian cancer. Key words: ovarian cancer; neoadjuvant chemotherapy; cytoreductive surgery; postoperative complications