Neoadjuvantna hemioterapija praćena intervalnom debulking hirurgijom nasuprot primarnoj debulking hirurgiji kod uznapredovalog epitelijalnog karcinoma jajnika – retrospektivna kohortna studija

  • Slobodan Maričić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Aljoša Mandić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Ninoslav Dejanović Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
  • Nebojša Kladar University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Marina Popović Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
  • Tatjana Ivković Kapicl University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Bojana Gutić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Dunja Kokanov Oncology Institute of Vojvodina, Sremska Kamenica, Serbia
DOI: https://doi.org/10.2298/VSP190110038M
Ključne reči: citoredukcija, hirurške procedure, lečenje lekovima, hirurgija, ginekološka, precedure, jajnik, neoplazme, preživljavanje, prognoza

Sažetak


Uvod/Cilj. Zlatni standard u lečenju uznapredovalog karcinoma jajnika (AOC) je primarna citoreduktivna hirurgija (PDS) nakon koje sledi adjuvantna hemioterapija na bazi platine. Kod AOC, opseg resekcije tumora (rezidualni volumen tumora) je najvažniji prognostički faktor za ukupno preživljavanje (OS) i preživljavanje bez progresije bolesti (PFS). Neoadjuvantna hemioterapija (NACT) praćena intervalnom citoreduktivnom hirurgijom (IDS) je eksperimentalni tretman AOC, uveden u kliničku praksu kako bi se poboljšala citoredukcija i produžilo preživljavanje. Cilj rada je bio da se uporedi stopa preživljavanja i citoredukcije između NACT + IDS i PDS kod bolesnica sa AOC. Metode. Retrospektivnom kohortnom studijom bile su obuhvaćene bolesnice sa AOC, podeljene u dve grupe. U grupi lečenoj PDS bilo je 59 bolesnica, dok su u grupi lečenoj NACT + IDS bile 33 bolesnice. Rezultati. Utvrđena je niža stopa suboptimalne citoredukcije (39,39%) u NACT + IDS grupi u poređenju sa PDS grupom (57,63%). Procenat potpune citoredukcije bio je viši kod bolesnica lečenih NACT + IDS (51,52%) nego kod onih lečenih PDS (38,98%). Ipak, OS I PDS nisu se značajno razlikovali između grupa (p < 0,05). OS je bilo 35 meseci u PDS grupi i 31 mesec u NACT + IDS grupi; PFS je bilo 16 meseci u PDS i 19 meseci u NACT + IDS grupi bolesnica. Zaključak. Uprkos višoj stopi optimalne citoredukcije nakon NACT + IDS, preživljavanje bolesnica lečenih na ovaj način nije bilo bolje od preživljavanja bolesnica lečenih metodom PDS. Odluku za primenu NACT + IDS ili PDS treba prilagoditi svakoj bolesnici.

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2021/12/23
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Vol. 78 Br. 11 (2021): Vojnosanitetski pregled
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Originalni članak