tumorsMalignant tumoursMalignant tumours2224-50572587-6813Rosoncoweb10.18027/2224-5057-2017-3-13-22tumors-387Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL REPORTSСпорные вопросы оптимальной тактики хирургического лечения больных распространенным раком яичниковControversies in surgical treatment of advanced ovarian cancerРумянцевА. А.RumyantsevA. A.

аспирант отделения клинической фармакологии и химиотерапии

MD, PhD, student, Department of Clinical Pharmacology and Chemotherapy

alexeymma@gmail.comТюляндинаА С.TjulandinaA. S.

к. м. н., старший научный сотрудник отделения клинической фармакологии и химиотерапии

MD, PhD, N.N. Blokhin Russian Cancer Research Center, Department of Clinical Pharmacology and Chemotherapy, Moscow, Russia, e-mail: atjulandina@gmail.com

atjulandina@gmail.comПокатаевИ. А.PokataevI. A.

к. м. н., старший научный сотрудник отделения клинической фармакологии и химиотерапии

MD, PhD, Department of Clinical Pharmacology and Chemotherapy

pokia@mail.ruТюляндинС. А.TjulandinS. A.

д. м. н., профессор, заведующий отделением клинической фармакологии и химиотерапии

MD, PhD, DSc, Professor, Head of the Department of Clinical Pharmacology and Chemotherapy

stjulandin@gmail.comФГБУ «Российский Онкологический Научный Центр им. Н. Н. Блохина»РоссияN. N. Blokhin Russian Cancer Research CenterRussian Federation201717112017031322Copyright © Румянцев А.А., Тюляндина А.С., Покатаев И.А., Тюляндин С.А., 20172017Румянцев А.А., Тюляндина А.С., Покатаев И.А., Тюляндин С.А.Rumyantsev A.A., Tjulandina A.S., Pokataev I.A., Tjulandin S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.malignanttumors.org/jour/article/view/387

У 70–80 % пациенток рак яичников диагностируется на поздних стадиях. Стандарт первичного лечения данной патологии – хирургическое удаление максимально возможного объема опухолевой ткани с последующей платиносодержащей химиотерапией. При этом существует альтернативный подход к лечению диссеминированного рака яичников, включающий предоперационную химиотерапию с последующим оперативным вмешательством. Известно, что достижение полной или оптимальной циторедукции является одним из важнейших факторов, определяющих прогноз пациенток. В связи с этим растет популярность предоперационной химиотерапии при раке яичников и не прекращаются оживленные споры между сторонниками различных подходов к лечению данной патологии. В статье обобщена существующая доказательная база, отражающая прогностическую роль первичных оптимальных и полных циторедукций у больных диссеминированным раком яичников. Результаты крупных рандомизированных исследований, посвященных прямому сравнению первичных и интервальных циторедукций, были критически проанализированы и сопоставлены с результатами лечения пациенток в практике ведущих онкологических клиник. Авторы постарались сделать выводы о роли интервальной циторедукции у больных раком яичников, а также обсудить пути улучшения результатов их лечения.

 

 

 

 

Approximately 70–80% patients with ovarian cancer are diagnosed at advanced stages. Surgical debulking followed by platinum based chemotherapy is a standard frontline treatment for this disease. There is another approach consisted of neoadjuvant chemotherapy followed by a debulking surgery which is on rise. In this article we reviewed the current evidence which highlights the importance of radical surgery aimed to achieve complete or optimal debulking in ovarian cancer patients. We analyzed the results of large randomized clinical trials addressed the issue of efficacy of primary and interval debulking surgery and compared their results to the data about treatment outcomes in leading cancer centers. We drew conclusions about the current role of interval debulking surgery and discussed the ways to improve patient outcomes.

 

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The authors declare that there are no conflicts of interest present.