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Original Abstract of the Article

Major research findings

Ovarian cancer is the most lethal gynecological cancer in women and is often diagnosed at an advanced stage, resulting in a generally poor survival rate. 27 assessed the clinical effectiveness of four main treatment options for epithelial ovarian cancer: i) adjuvant chemotherapy and/or adjuvant radiotherapy, ii) cytoreductive surgery, iii) neoadjuvant chemotherapy in advanced disease, and iv) postoperative chemotherapy in advanced disease. 51 , 43 , and 54 emphasized the importance of cytoreductive surgery in advanced ovarian cancer, as the size of the tumor significantly impacts survival rates. 68 suggested that hyperthermic intraperitoneal chemotherapy (HIPEC) may improve the long-term outcomes of patients with primary advanced ovarian cancer. However, studies 34 and 62 show that adjuvant chemotherapy after surgery is effective in improving survival rates for early-stage ovarian cancer. Furthermore, 69 highlighted antigen-specific active immunotherapy as a promising new treatment option for ovarian cancer, aiming to induce tumor-specific immune responses to inhibit tumor growth.

Treatment Summary

27 explored four treatment options for ovarian cancer: adjuvant chemotherapy and/or adjuvant radiotherapy, cytoreductive surgery, neoadjuvant chemotherapy in advanced disease, and postoperative chemotherapy in advanced disease. 53 examined the effectiveness of pegylated liposomal doxorubicin (PLD) for relapsed ovarian cancer. PLD, containing the cytotoxic drug doxorubicin hydrochloride, can be used as a single-agent therapy or in combination with other drugs. 72 discussed follow-up care after treatment, hormone replacement therapy, and contraceptive options for patients with ovarian cancer. 39 pointed out that women undergoing ovarian cancer surgery frequently utilize healthcare services due to the various treatment modalities, complications, and side effects associated with those treatments. 61 analyzed the cost-effectiveness of chemotherapeutic agents and targeted biologics used in ovarian cancer treatment.

Benefits and Risks

Benefit Summary

Treatment for ovarian cancer varies depending on the stage of the tumor and the patient's condition. However, numerous studies suggest that treatments like cytoreductive surgery, chemotherapy, and radiation therapy effectively improve survival rates. 27 , 51 , 43 , 54 , 34 , 62 , 3 , 6 , 1 , 16 , and 69 indicate the potential of various treatments to improve survival. 73 suggests that neoadjuvant chemotherapy and interval debulking surgery, when combined with postoperative chemotherapy, may increase complete cytoreductive surgery rates and reduce postoperative complications and mortality.

Risk Summary

Treatment for ovarian cancer carries the risk of side effects. Chemotherapy can cause side effects like nausea, vomiting, hair loss, and bone marrow suppression. 53 , 16 , 66 , 6 , 1 , and 78 mention the side effects of chemotherapy. Radiation therapy can cause skin inflammation, fatigue, and digestive problems. 3 reported a case of small bowel injury requiring surgery due to radiation therapy. Surgery can lead to complications like bleeding, infection, and pain. 73 addressed the risks of complications associated with surgery.

Research Comparison

Commonalities

Multiple studies highlight the importance of cytoreductive surgery and chemotherapy in treating ovarian cancer. 27 , 51 , 43 , 54 , 34 , 62 , and 73 acknowledge the crucial role of surgery and chemotherapy in ovarian cancer treatment. Numerous studies indicate that chemotherapy effectively controls the recurrence of ovarian cancer. 53 , 26 , 36 , 21 , and 33 discuss the role of chemotherapy in preventing recurrence. 65 explored the role of targeted therapy in ovarian cancer treatment.

Differences

Treatment approaches for ovarian cancer differ across studies. For example, 27 evaluated four treatment options: adjuvant chemotherapy and/or adjuvant radiotherapy, cytoreductive surgery, neoadjuvant chemotherapy in advanced disease, and postoperative chemotherapy in advanced disease, while 53 examined the effectiveness of pegylated liposomal doxorubicin (PLD) for relapsed ovarian cancer. 72 focused on follow-up care, hormone replacement therapy, and contraceptive options after treatment. 70 investigated the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) for assessing the resectability of advanced ovarian cancer. 74 evaluated the effectiveness of gemcitabine treatment for recurrent ovarian cancer. These variations demonstrate the diverse treatment approaches and perspectives explored in research.

Consistency and Contradictions in Results

Some contradictions exist in research results regarding ovarian cancer treatment. For instance, 3 questioned the effectiveness of radiation therapy for advanced ovarian cancer, while 20 suggested that radiation therapy may improve survival rates depending on the size of the residual tumor after surgery. 60 proposed the effectiveness of neoadjuvant chemotherapy for advanced ovarian cancer, while 73 suggested a potential benefit of neoadjuvant chemotherapy and interval debulking surgery in combination with postoperative chemotherapy. These discrepancies highlight the need for further research to validate and refine treatment approaches.

Considerations for Real-World Application

Treatment for ovarian cancer is tailored to the patient's individual condition and the stage of the tumor. Therefore, directly applying research findings to everyday life is not appropriate. Consulting a physician is crucial to determine the most suitable treatment options. Moreover, treatments like chemotherapy and radiation therapy have potential side effects, so following a doctor's instructions and implementing preventive measures for side effects management is essential. 53 , 16 , 66 , 6 , 1 , and 78 discuss the side effects of chemotherapy. Additionally, research on novel treatment options for ovarian cancer, especially targeted therapies, is ongoing. 65 and 80 provide insights into this evolving landscape.

Limitations of Current Research

Research on ovarian cancer treatment is still developing, with several limitations. For instance, 3 pointed out the challenge of obtaining statistically reliable conclusions due to small sample sizes in some studies. 5 emphasized the need for central pathology review to effectively evaluate treatment outcomes. These limitations highlight the ongoing need for research to address these challenges and improve the reliability of findings.

Future Research Directions

To enhance treatment outcomes for ovarian cancer, further research is essential. Research focusing on developing novel treatment options and validating the effectiveness of existing therapies is crucial. 69 highlights the promise of antigen-specific active immunotherapy, which aims to induce tumor-specific immune responses to suppress tumor growth. 61 explored the cost-effectiveness of chemotherapeutic agents and targeted biologics used in ovarian cancer treatment. Therefore, research on developing new therapies, validating existing treatment effectiveness, and evaluating cost-effectiveness is vital. 48 suggested the importance of investigating the impact of ovarian cancer tumor biology on surgical success. Research focusing on tumor biology is also critical.

Conclusion

Ovarian cancer remains a challenging disease with ongoing research efforts. This summary provides insights into the latest research findings on ovarian cancer treatment. Treatment approaches vary based on the patient's condition and tumor stage. Therefore, directly applying research findings to everyday life is not appropriate. Consult a physician for personalized advice and treatment recommendations. Remember that treatment options like chemotherapy and radiation therapy have potential side effects, so adhering to a doctor's instructions and managing side effects is essential.

Treatment List

Adjuvant chemotherapy, adjuvant radiotherapy, cytoreductive surgery, neoadjuvant chemotherapy, postoperative chemotherapy, pegylated liposomal doxorubicin (PLD), hormone replacement therapy, contraception, hyperthermic intraperitoneal chemotherapy (HIPEC), antigen-specific active immunotherapy, gemcitabine, targeted therapy, platinum-based chemotherapy, paclitaxel, topotecan, ifosfamide, cyclophosphamide, adriamycin, cisplatin, vincristine, high-dose methotrexate, bevacizumab, PARP inhibitors


Keywords
Benefit Keywords
Risk Keywords
Literature analysis of 87 papers
Positive Content
83
Neutral Content
3
Negative Content
1
Article Type
29
27
52
47
87

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Author: HarterPhilipp, SehouliJalid, VergoteIgnace, FerronGwenael, ReussAlexander, MeierWerner, GreggiStefano, MosgaardBerit J, SelleFrederic, GuyonFrédéric, PomelChristophe, LécuruFabrice, ZangRongyu, Avall-LundqvistElisabeth, KimJae-Weon, PonceJordi, RaspagliesiFrancesco, KristensenGunnar, ClasseJean-Marc, HillemannsPeter, JensenPernille, HasenburgAnnette, Ghaem-MaghamiSadaf, MirzaMansoor R, LundBente, ReinthallerAlexander, SantaballaAna, OlaitanAdeola, HilpertFelix, du BoisAndreas,


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