Bevacizumab, discredited?

Do medicines that restrict new blood vessel growth (angiogenesis inhibitors) help women with epithelial ovarian cancer?

https://tinyurl.com/yc3f886y

 

       Bevacizumab has been used in the first-line treatment of ovarian cancer for 5 years. It is expensive, although biosimilar cheaper alternatives are now available, and causes significant side effects for many women, with hypertension, stroke and bowel perforation as possible fatal adverse reactions.

       An analysis of all available literature, done by the Cochrane Collaboration looked at treatment with Bevacizumab for patients with epithelial ovarian cancer, with the purpose of determining if it is effective.

       Results showed no benefit for women who commenced treatment as maintenance after initial therapy. Quality of life is decreased with Bevacizumab treatment and significant side effects increased. There is no increase in overall survival. Only women who are platinum resistant have significant increase in progress free survival.

Better CT scans

Imaging ovarian cancer – from baseline characteristics to high-risk image factors

https://tinyurl.com/y6dz4p48

 

       Most patients with ovarian cancer have a CT scan. The purpose of the scan is partly to confirm the diagnosis, but mostly to demonstrate the extent of the disease. 

       Currently a full CT report involves determination of the presence or absence of disease at 13 sites. It takes time and may be subjective.

       This retrospective study looked at historical CT scans from patients with known outcomes. A new CT scan report, named the short score, was restricted to review of two features; peritoneal carcinomatosis (usually seen as ascites) and enlarged diaphragmatic lymph nodes. Close correlation is seen between the score, the stage of the cancer and survival. 

       The authors suggest using the score reduces the time to diagnosis and improves the objectivity.

Non-justified surgery

Analysis of prognosis and associated factors in multiple recurrent epithelial ovarian cancer with three or more cytoreductive surgeries.

https://tinyurl.com/rsx6jyhc

 

      A trend in the management of ovarian surgery is more aggressive intervention looking for total clearance of residual tumour. Because the outcomes for patients with recurrent ovarian cancer is so poor, many such women now have multiple attempts to do so.

      Whether this is appropriate is debatable. This study looks at women who have had three or more attempts at clearance surgery. 

      The results show a diminishing effectiveness of such surgery with poor outcomes and significantly increased adverse result. The authors suggest that more than two attempts at surgical clearance is unlikely to provide significant benefit.

ChatGPT & us

Significance of cholecystectomy in cytoreductive surgery for advanced ovarian cancer

https://tinyurl.com/2t3em4fr

 

       This summary of the above article was produced using ChatGPT. I asked for a general interest summary. The following is the sixth attempt. It is accurate and easily read. You might consider doing the same for any other stuff that is of interest to you.

       “The article published in BMC Surgery investigates the significance of cholecystectomy during cytoreductive surgery for advanced ovarian cancer. The study analyzed data from 225 patients who underwent cytoreductive surgery, and the authors found that cholecystectomy was associated with longer operative times and increased blood loss, but it did not significantly affect the rate of postoperative complications or mortality.

       The study suggests that cholecystectomy may be beneficial for patients with advanced ovarian cancer who have gallbladder involvement, as it may improve survival outcomes. However, the procedure should be performed with careful consideration of the potential risks and benefits.

       Overall, the study provides important insights into the role of cholecystectomy in cytoreductive surgery for advanced ovarian cancer patients with gallbladder involvement. These findings can guide clinicians in making informed treatment decisions for their patients”.