By Eric Pujade-Lauraine, Isabelle Ray-Coquard, Fabrice Lécuru
This ebook offers an summary of the most recent advancements within the recommendations and administration of ovarian melanoma. the recent information provided all through opens easy methods to considerably diverse healing ways. surgical procedure continues to be the center of ovarian melanoma therapy, yet its final aim and the normal surgery have developed, giving upward push to the query of the way to label specialist facilities for debulking surgical procedure. Neo-adjuvant chemotherapy is rising in popularity and is usually a brand new box for checking out novel drug combinations.
Over fresh years, ovarian melanoma administration has embraced molecular biology. it truly is now extra right to discuss cancers of the ovary instead of ovarian melanoma, because it isn't really a distinct sickness yet a number of entities with diversified molecular drivers. the numerous advances in medicines concentrating on the microenvironment or the tumor telephone DNA fix mechanisms are offered intimately including fascinating destiny perspectives.
All those advances shouldn't have been attainable with out collaborative teams comparable to the GINECO team in France and their integration in wider scientific study networks on the eu (ENGOT) and foreign (GCIG) level.
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Extra resources for Ovarian Cancers: Advances through International Research Cooperation (GINECO, ENGOT, GCIG)
Pal et al. 5 % of the series) . 8)], including 5 MSH6 mutations, 2 MLH1 mutations and 2 MSH2 mutations. Walsh et al. screened 21 tumour suppressor genes, including MLH1, MSH2, MSH6 and PMS2, in a series of 360 women with primary ovarian, peritoneal or fallopian tube carcinoma . Cases of mucinous ovarian cancer were excluded. Most tumours (91 %) were high-grade tumours. 5 %), with no MLH1, MSH2 or PMS2 mutations. It is noteworthy that the only MMR gene found mutated in this series of cases selected for type 2 OC, while Lynch syndrome-associated OCs tend to be type 1, was MSH6.
Survival was lower than expected; surgical output was questionable since a complete resection was obtained in a minority of patients after primary surgery. Interestingly, the correlation between survival and residual disease was similar to that described by Bristow R. The second intriguing result was that complete/optimal resection was significantly more common after interval surgery, but this did not translate into improvement of survival. Size of the disease was also a concern, since size of the largest metastasis was 10 cm or more in 40 % of patients of the EORTC trial, indicating that the worse patients had been included in these studies.
Reported that patients with upper abdominal disease had a worse prognosis, even with a complete resection when compared to patients with carcinomatosis limited to the pelvis . More recently, Horowitz et al. reported recently on the correlation between initial extent of the carcinomatosis, aggressiveness of surgery, and survival . Complete resection was once more associated to longer survival, whatever the initial disease burden. But among patients without residual disease, prognosis significantly varied with the initial extent of the disease.