Emerging Concerns When Evidence-Based Medicine Is Translated into Real Life: The Case of Neoadjuvant Chemotherapy in Ovarian Cancer
González-Martín A (1), Chiva L.
More than 70 % of patients with epithelial ovarian cancer are diagnosed with an advance stage of disease. For decades, the therapeutic approach to these patients has consisted of cytoreductive surgery followed by a platinum-based chemotherapy regimen.
Although there are no randomized clinical trials confirming that cytoreductive surgery improves survival, several retrospective studies as well as one meta-analysis have shown that the most important prognostic factor for patients with advanced epithelial ovarian cancer is the amount of residual disease after surgical cytoreduction [1, 2].
Constantly in the literature, the absence of macroscopic residual disease after debulking surgery has been associated with better overall survival [3–5]. Recently, the fourth Ovarian Cancer Consensus Conference stated that the expression “optimally debulked patients” should be reserved for those patients without residual macroscopic disease after debulking surgery.
CITATION Curr Oncol Rep. 2013 Feb;15(1):4-6. doi: 10.1007/s11912-012-0278-0