By Gene Emery
(Reuters Health) – When you return to the operation in the operating room to help a woman whose ovarian cancer has recurred, this may not lead to a longer life study involving 485 women.
"I believe this study will reduce the number of such surgeries," Dr. Robert Coleman from the University of Texas Anderson Cancer Center in Houston, Texas, lead author of the study published in the New England Journal of Medicine.
The operations are currently considered a standard medical care. However, the new evidence suggests that women undergoing chemotherapy alone when their tumors re-emerge are as good or better than women undergoing chemotherapy.
The results apply only to women whose tumors are sensitive to platinum-based drugs. [1
This equates to an increase of 29% in the mortality rate for the recipients of the surgery.
According to the American Cancer Society, approximately 22,500 women in the United States suffer from ovarian cancer each year. However, in more than 80% of women the disease recurs, the 10-year survival rate is below 15%, and it is expected that about 14,000 women will die of their tumors. About half of the affected women have platinum-sensitive tumors. About a quarter of the patients are candidates for a secondary operation when the tumor recurs.
The study known as GOG-0213 ended early, when preliminary results showed that the surgery was not helpful. The subjects had recurrent epithelial ovarian, primary peritoneal or fallopian tube cancer.
Coleman told Reuters Health in a telephone interview that the results are surprising, however, the effectiveness of the secondary surgery had not been tested and the results likely reflect the following fact that chemotherapy for ovarian cancer has improved significantly.
The women in the study "lived three times longer than at the beginning of the study," said Coleman, senior executive director of cancer network research at MD Anderson.
Sixty-seven percent of the patients in the surgical group survived three years, while 74 percent received chemotherapy alone.
did not differ significantly between the two groups after recovery, "the study team wrote, and the two groups reached a quality of life agreement after six weeks.
According to Coleman, MD Anderson and other cancer centers are routine discontinued secondary surgery, however, it may take time for other medical interventions centers that follow this example.
"There are definitely physicians who believe there is a benefit in their hands and in their specific patients, even if the study shows no benefit, and many patients would want it, "he said." Most people who see cancer want to turn it off. "
SOURCE: https://bit.ly/33CobKG The New England Journal of Medicine, online, November 13, 2019.