ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 17 of 48
JMBS 2018, 3(2): 93–100
Clinical Medicine

Analysis of the Results of Combined Treatment of Ovarian Cancer Patients

Mihanovskii A. A., Kochina M. L. 2, Kharchenko Yu. V., Fedorenko N. V., Schit N. M.

The purpose of the study was the comparative analysis of the results of combined treatment of patients with common ovarian cancer. In this article we present the results of clinical observation of 129 patients with ovarian cancer on the III-IV (T3a-sNhM0-1) stages of the disease. These patients were treated under supervision of "GIMR NAMS of Ukraine" from 2014 to 2017. To conduct the comparative analysis of different treatment regimens effectiveness, the patients were divided into three groups. Patients in the first group (7% of all patients) received I-II cycles of neoadjuvant chemotherapy with subsequent surgical treatment; the second group patients (58.9%) got III-IV cycles of neoadjuvant chemotherapy with subsequent operative training; and the third group patients (34.1%) underwent surgical treatment followed by adjuvant chemotherapy. Analysis of the ovarian cancer (OC) patients distribution, depending on the stage of the disease and the histological structure of the tumor, allowed to establish that in patients with stage III of OC, serous cystadenocarcinoma is more likely to be detected more frequently than other types of tumors (χ2=13.4; p <0.05). At stage IV of the disease, there were no significant differences in the incidence of serous cystadenocarcinoma and other types of tumors. It was found out that in the IV stage of the OC there were significantly more frequent low-differentiated adenocarcinoma (χ2=6.1; p <0.05), serous cystadenocarcinoma or low-differentiated adenocarcinoma (χ2=5.9; p <0.05) than other types of tumors comparing with the III stage. The operative treatment of OC patients was to carry out the most possible cytodecimal operation. The extirpation or superficial amputation of the uterus with appendages in combination with resection or extirpation of the large gland was performed in 101 (78,2 ± 3,6)% of patients. The analysis of the relapse period in OC patients, depending on the stage of the disease and the scheme of antitumor therapy, showed that the average non-recurring survival rate of patients in all studied groups was in the range of 24.4 to 30 months. During the first year OC relapses occurred in 49 patients (89% of the number all patients with relapse). Differences in the relapses occurrence frequency in the first year of observation and later dates are reliable according to the criterion χ2 (χ2=33.5; p <0.05). It was established that the disease relapse risk is 3.7 times higher in the 7-12 months after treatment than 1-6 months after treatment (OR=3.7; F=0.006436). The risk of its relapse in the first a year is 9.8 times higher than relapsing on a later date (OR=9.38; F=0.000000). The analysis of relapses nature showed that the most often progression of the tumor process in patients, regardless of antitumor therapy scheme, was noted in the pelvic area (loco-regional relapse) – 24 (38.7%) patients and its generalization in the abdominal cavity or distant metastases – 27 (43.0%) patients. There were 87.3% of all relapses detected in the group of patients over the age of 51. Thus, the age of OC patients older 50 years increases the risk of relapse by 41 times (OR=41.14; F=0.000000) compared with the younger age. 16 OC patients (12.5±2.9) % died during observation. The most numerous (p<0.05) age groups of the surviving patients were 51-60 and 61-70. The biggest (p<0,05) age group among the deceased was 61-70. It was also established that the histological form of OC influences the disease prognosis. The risk of lethality is more than 4 times increased by the mucinous tumor compared with other types of tumors.

Keywords: ovarian cancer, relapse, combined treatment, survival

Full text: PDF (Ukr) 276K

  1. Rak v Ukrayini, 2015–2016. Zakhvoryuvanist, smertnist, pokazniki diyalnosti onkologichnoyi sluzhbi. Uklad: Fedorenko ZP, Gulak LO, Mikhaylovich YuY, ta in. Byulleten natsionalnogo kantser-reyestru Ukrayini. K, 2016; 18: 123 s. [Ukrainian]
  2. Molchanov SV, Kolomiets LA. Disseminirovannyy rak yaichnikov: vozmozhnosti khirurgicheskogo lecheniya. Sibirskiy onkologicheskiy zhurnal. 2014; 5: 54–9. [Russian]
  3. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ. Cancer statistics, 2008. CA Cancer J Clin. 2008; 58: 71–96.
  4. Mikhanovskiy AA, Sudina EN. Analiz effektivnosti kombinirovannogo lecheniya s neoadyuvantnoy khimioterapiey u bolnykh rakom yaichnikov. Mizhnarodniy medichniy zhurnal. 2014; 20 (2): 80–7. [Russian]
  5. Prokopyuk AV, Mikhanovskiy AA, Pavlova TD, i dr. Vliyanie kolichestva kursov neoadyuvantnoy polikhimioterapii na UZI-semioticheskie kharakteristiki raka yaichnika III – IV stadii. Onkologiya. 2006; Spets vyp: 48. [Russian]
  6. Park Y, Lee JH, Hong DJ, Lee EY, Kim S-H. Diagnostic performances of HE4 and CA125 for the detection of ovarian cancer from patients with various gynecologic and non-gynecologic diseases. Clin Biochem. 2011; 44 (10–11): 884–8.
  7. Amram-Benamran ML, Cochet S, Petignat P, Sappino AP. Ovarian cancer screening: recommendations for clinical pratice. Rev Med Suisse. 2010; 6 (250): 1062–8.
  8. Jaffré I, Bordes V, Dejode M, et al. The role of interval surgery in the treatment's strategy of advanced ovarian cancer. Bull Cancer. 2011; 98 (1): 37–42.
  9. Melko AI, Kira EF, Ashrafyan LA., Ermolinskiy II. Blizhayshie i otdalennye rezultaty kombinirovannykh operatsiy pri rake yaichnikov Ivstadii. Akusherstvo i ginekologiya. 2007; 6: 36–8. [Russian]
  10. Ferster E, Rents B. Metody korrelyatsionnogo i regressionnogo analiza. M: Finansy i statistika, 1983. 302 s. [Russian]