Long‑term survival in ovarian cancer patients with FIGO IV classification

01/2019

MUDr. Adam Guňka

Komplexní onkologické centrum, Krajská nemocnice T. Bati, Zlín

SUMMARY

Ovarian cancer is one of the most aggressive oncological diseases and it has the highest mortality amongst gynecological malignancies. It is the fifth most common cause of death in women with malignant neoplasms all over the world. A wide variety of histological units is present in ovarian cancer and the most common type is a serosal ovarian cancer that belongs to a group called epithelial tumours.¹ In 2016, 998 new patients were diagnosed with ovarian cancer and in the same year 628 women died from the ovarian cancer in the Czech Republic.² The statistics show that this type of neoplasm is not very common, however, the mortality rates are one of the highest for this type of cancer. 75 % of diagnosed patients are already in advanced or metastatic stages. The main reasons are rapid tumour growth and late onset of symptoms. On top of that we are still very behind with getting tested and diagnosed in time. Despite aggressive treatment the percentage to survive at least five years is 23-35 % with Stage III, 10 % with Stage IV.³ The standard treatment of ovarian cancer is the combination of surgical treatment and chemotherapy. With surgery the tumours should drastically shrink and then systemic therapy should be in place. The ovarian cancer is generally highly chemo sensitive tumor and platinum derivative preparations are primarily used in the treatment. Primarily, for relapse we use systemic treatment, surgical treatment is used very rarely. Depending on the time when the primary or prior treatment ended we can distinguish platinum-resistant disease (relapse within six months of termination of the platinum-based treatment) and platinum-sensitive disease (relapse after more than six months after termination of the platinum-based treatment). Based on these two types of diseases we then choose other products for systemic therapy of the disease. Most common chemotherapeutic agents are carboplatin or cisplatin, paclitaxel, docetaxel, gemcitabine or pegylated liposomal doxorubicin. Medicine with a non-cytotoxic mechanism used in palliative systemic therapy can be for example bevacizumab or olaparib

KEY WORDS

chemotherapy, platinum-resistant ovarian cancer, platinum-sensitive ovarian cancer, treatment algorithm, quality of life