maj
Alba Plana- Institutionen för kliniska vetenskaper, Lund
Title: Refining the diagnosis to tailor ovarian cancer treatment
Main supervisor: Päivi Kannisto, docent
Reviewers: Pia Teleman, docent; Erik Baubeta Fridh, PhD.
Abstract
Background
Epithelial ovarian cancer is often detected at advanced stages.
The treatment for advanced ovarian cancer is surgery with the intention of complete resection of all macroscopic disease followed by chemotherapy. An alternative approach is neoadjuvant chemotherapy followed by interval debulking surgery. The lack of residual disease after surgery is the most important prognostic factor. Assessing the extent of disease and the feasibility of a successful surgery is of the utmost importance.
In 80–85% of patients, however, the disease recurs. Introduction of Poly (ADP-ribose) polymerase (PARP) inhibitors provides hope for these patients, as several studies have shown extended progression-free survival for patients whose tumor shows mutations in Breast Cancer (BRCA) genes and other Homologous recombination deficiencies (HRD). Almost 50% of all high-grade ovarian cancers have HRD.
Research questions
- Can the presence of enlarged cardiophrenic lymph nodes (CPLNs), visualized by computed tomography (CT), and CA-125 be used to assess diaphragmatic carcinomatosis and residual disease in advanced ovarian cancer patients treated with upfront surgery? Do CT-CPLNs have any prognostic role of in overall survival?
- How has the implementation of BRCA mutated ovarian cancers gone in the Southern Region? How has it developed with further HRD testing?
- Is specialist gynecologic ultrasound a reliable examination technique for evaluating the tumor spread that we find during surgery? Is a specialist ultrasound or computed tomography examination most suitable for assessing the amount of tumor in the patient preoperatively?
- Has the survival of those patients with a higher PCI short score been different than those with a lower one? Does the survival correlate with the PCI short score as well as it does with the PCI?
Preliminary results
- We observed that enlarged CPLNs on CT scans and CA-125 levels correlate with diaphragmatic carcinomatosis and RD at the end of the surgery. The strongest prognostic factor for OS remains CCS, regardless of the CT-CPLN status.
Significance
Ovarian cancer is often diagnosed when is already at an advanced stage. Being able to determine the best treatment option for every patient can improve patient outcome and reduce unneeded morbidity.
Published studies
- Plana A, Talo R, Wallengren NO, Pudaric S, Sartor H, Asp M. Radiologically enlarged cardiophrenic lymph nodes and CA-125 in relation to diaphragmatic carcinomatosis, surgical outcome, and overall survival in advanced ovarian cancer. Acta Oncol. 2023 May;62(5):451-457.
Om evenemanget
Plats:
Föreläsningssalen KK vån 3, SUS Klinikgatan 12 Lund
Kontakt:
alba [dot] plana_gutierrez [at] med [dot] lu [dot] se