quality of care for patients with advanced ovarian carcinoma

To assess the quality of care for patients with advanced ovarian carcinoma at Mansoura University Teaching Hospital. Case notes of 96 patients with advanced ovarian carcinoma [stages III-IV] were reviewed. Operative intervention was carried out by Gynecologists in 50 patients and optimal debulking was achieved in 19 [38%]. A combined team of Gynecologists and Surgeons achieved optimal debulking in 17/21 [81%], while general surgeons achieved optimal debulking in 5/25 [20%] of patients. 78% of patients completed 6 cycles of platinum based chemotherapy. The median progression-free and overall survival was 16 and 22.9 months respectively. Optimal cytoreduction was the single favorable prognostic factor. Patients were managed on individual basis with no specialization or multi-disciplinary team management. Multidisciplinary surgical management achieved the best survival for patients with advanced ovarian carcinoma. Centralization of care and surgical sub-specialization are still suboptimal in Mansoura

Paclitaxel plus carboplatin versus carboplatin alone in women with platinum-sensitive recurrent ovarian carcinoma

To compare the efficacy and safety of paclitaxel plus carboplatin versus carboplatin alone in the treatment of patients with platinum-sensitive recurrent ovarian carcinoma. Forty patients with platinum-sensitive ovarian carcinoma relapsing after 6 months of being treatment-free and with no more than two previous chemo-therapy lines were enrolled in this trial. Twenty one patients were randomized to receive carboplatin [300 mg/m[2] and 19 to receive the same dose of carboplatin plus paclitaxel [175mg/m[2] The primary outcome measure was objective response. Secondary outcomes were progression-free survival [PFS], overall survival [OS] and toxicity. The response rate in the combination arm was 79% [26% complete response [CR] and 53% partial response [PR]] compared with 48% in the carboplatin arm [19% CR and 29 PRI [p=0.041]. Median PFS was higher in paclitaxel carboplatin arm [12 versus 8 months]. Median OS was also better in the combination arm [24 versus 18 months]. However, these differences were not statistically significant [p=0.23 and 0.35 respectively]. No significant differences were observed in grade 3-4 hematological toxicity. Conversely, alopecia, mucositis, myalgia/arthralgia and sensory neuropathy were more frequent in the combination arm and the differences were statistically significant [p=0.0009, 0.027, 0.001, and 0.027 respectively]. Paclitaxel plus carboplatin is a tolerable regimen. It seems to be more effective among patients with platinum-sensitive recurrent ovarian carcinoma compared with single-agent carboplatin