The role of surgery in the management of patients with platinum-sensitive recurrent ovarian cancer: survey among Dutch gynecologists and medical oncologists.
OBJECTIVE
Evidence of randomized comparative clinical trials on surgery in recurrent platinum-sensitive ovarian cancer is non-existing. Three randomized phase 3 trials are ongoing. The aim of this study is to evaluate the current opinion of Dutch gynecologists and medical oncologists awaiting the results of these three trials.


METHODS
A 16-item questionnaire was sent to all gynecologists (N=124) and medical oncologists (N=195) with special interest in gynecologic oncology in the Netherlands. The data were collected and analyzed using descriptive statistics.


RESULTS
In total, 80 (65.0%) gynecologists and 67 (34.0%) medical oncologists responded. Among the respondents, 11.3% and 26.9% were not convinced of the benefit of secondary cytoreductive surgery, respectively. For most gynecologists and medical oncologists completeness of primary surgery (74.6% and 75.5%, respectively) and performance status (100% and 98%, respectively) were important factors when considering surgery. For only about 17.5% of all respondents diagnostic laparoscopy before surgery is a prerequisite. Most respondents (81.7% and 87.8%, respectively) would use platinum-based chemotherapy with paclitaxel as their agents of choice after surgery. In general medical oncologists settle for a smaller gain in both progression free as well as overall survival than gynecologists.


CONCLUSIONS
Although most gynecologists and medical oncologists are already convinced of the usefulness of secondary cytoreductive surgery in certain patients, a better understanding of the real advantages and disadvantages and patient's selection criteria for secondary cytoreductive surgery will be achieved after the completion of three ongoing randomized controlled trials (DESKTOP III, GOG 213 and the SOCceR).
Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands; GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. Electronic address: r.vandelaar@obgyn.umcn.nl.
Rafli
R
van de Laar
Petra L M
PL
Zusterzeel
Toon
T
Van Gorp
Petronella B
PB
Ottevanger
Leon F A G
LF
Massuger
Roy F P M
RF
Kruitwagen
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D016190:Carboplatin / Q000008:administration & dosage; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D017326:Clinical Trials, Phase III as Topic; D003625:Data Collection; D005260:Female; D006176:Gynecology; D006801:Humans; D008495:Medical Oncology; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy / Q000601:surgery*; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
Recurrent ovarian cancer; Secondary cytoreductive surgery