Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 9A - How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
Three Cycles
from Section III - Ovarian Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
High-risk stage I ovarian cancer includes clear cell and grade 3 tumours. ESMO–ESGO guidelines suggests carboplatin in monotherapy for six cycles or the combination of carboplatin and paclitaxel for a minimum of three cycles as available options for adjuvant treatment in this setting. Nevertheless, there is not a study that compare the two options. On the basis of data available, three cycles of carboplatin plus paclitaxel represents an effective strategy to reduce the probability of recurrence in high-risk early-stage ovarian cancer patients, especially in non-serous tumors. Three cycles compared with six cycles of carboplatin and paclitaxel do not significantly alter the recurrence rate in high-risk ovarian cancer, but six cycles are associated with more toxicity.
- Type
- Chapter
- Information
- 50 Big Debates in Gynecologic Oncology , pp. 47 - 48Publisher: Cambridge University PressPrint publication year: 2023
References
Colombo, N, et al. ESMO-ESGO Ovarian Cancer Consensus Conference Working Group. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Ann Oncol 2019;30(5):672–705.CrossRefGoogle Scholar
Lawrie, TA, et al. Adjuvant (post-surgery) chemotherapy for early stage epithelial ovarian cancer. Cochrane Database Syst Rev 2015;12:CD004706.Google Scholar
Bell, J, et al. Randomized phase III trial of three versus six cycles of adjuvant carboplatin and paclitaxel in early stage epithelial ovarian carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2006;102:432–439.CrossRefGoogle ScholarPubMed
Chan, JK, et al. The potential benefit of 6 vs. 3 cycles of chemotherapy in subsets of women with early-stage high-risk epithelial ovarian cancer: an exploratory analysis of a Gynecologic Oncology Group study. Gynecol Oncol 2010;116:301–306.CrossRefGoogle ScholarPubMed
Prendergast, H, et al, Three versus six cycles of adjuvant platinum-based chemotherapy in early stage clear cell ovarian carcinoma – A multi-institutional cohort. Gynecol Oncol 2017;144:274–278.CrossRefGoogle ScholarPubMed