Neoadjuvant chemotherapy in gynaecological cancers - Implications for staging.

Abstract

The management of advanced gynaecological cancers remains a therapeutic challenge. Neoadjuvant chemotherapy has been used to reduce tumour size, thus facilitating subsequent local treatment in the form of surgery or radiation. For advanced epithelial ovarian cancer, data from several non-randomized and one randomized studies indicate that neoadjuvant chemotherapy followed by interval debulking surgery is a reasonable approach in patients deemed inoperable. Such an approach results in optimum debulking (no visible tumour) in approximately 40% of the patients with reduced operative morbidity. Overall and progression free-survival is comparable to the group treated with primary debulking surgery followed by chemotherapy. Neoadjuvant chemotherapy followed by surgery is associated with improved survival for women with stage IB2-IIA cervix cancer. There is a resurgence of interest for using short-course neoadjuvant chemotherapy prior to concurrent chemo-radiation. Currently, this is being tested in randomized trials.

• Authors: Lalit Kumar, Raja Pramanik, Sunesh Kumar, Neerja Bhatla, Shilpa Malik
• Journal: Best practice & research. Clinical obstetrics & gynaecology (Best Pract Res Clin Obstet Gynaecol) Vol. 29 Issue 6 Pg. 790-801 (Aug 2015) ISSN: 1532-1932 [Electronic] Netherlands
• PMID: 25840650 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Ovarian Epithelial
• Chemotherapy, Adjuvant
• Cytoreduction Surgical Procedures
• Disease-Free Survival
• Female
• Humans
• Neoadjuvant Therapy
• Neoplasm Staging
• Neoplasms, Glandular and Epithelial (drug therapy, pathology)
• Ovarian Neoplasms (drug therapy, pathology)
• Prognosis
• Treatment Outcome
• Uterine Cervical Neoplasms (drug therapy, pathology)