Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis
Background Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a ne...
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| Veröffentlicht in: | Annals of surgical oncology 2009-05, Vol.16 (5), p.1324-1330 |
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| creator | Harter, P. Hahmann, M. Lueck, H. J. Poelcher, M. Wimberger, P. Ortmann, O. Canzler, U. Richter, B. Wagner, U. Hasenburg, A. Burges, A. Loibl, S. Meier, W. Huober, J. Fink, D. Schroeder, W. Muenstedt, K. Schmalfeldt, B. Emons, G. du Bois, A. |
| description | Background
Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.
Methods
Exploratory analysis of the DESKTOP I trial (multicenter trial of patients undergoing surgery for recurrent ovarian cancer, 2000 to 2003).
Results
A total of 125 patients (50%) who underwent surgery for recurrent ovarian cancer had peritoneal carcinomatosis. Univariate analyses showed worse overall survival for patients with peritoneal carcinomatosis compared with patients without carcinomatosis (
P |
| doi_str_mv | 10.1245/s10434-009-0357-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67111486</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>67111486</sourcerecordid><originalsourceid>FETCH-LOGICAL-c369t-530fd16af516a0b4bf01a64c6c84a2830f6de2daad98b598b2cd122c9bf4dfc63</originalsourceid><addsrcrecordid>eNp9UU2P0zAQtRCIXQo_gAuyOHAi4O8me6tKFypWatUtXCPHcRYvjl3sBNGfyT9iolZaCQkOHo_nvXkz8kPoJSXvKBPyfaZEcFEQUhWEy3lBHqFLKqEiVEkfQ05UWVRMyQv0LOd7QuicE_kUXdCKMVkKcYl-347pzqYj7mLCO2vGlGwY8OanTk4HvNTB2HSFd9FbHDu8tckNMVjtAUrGhdjrIWaXr_Dq18HHBC8QWwTtj1CdWoZvFn9Y3X7eb7Z4jfcg6_GiieOAdy5_x9faQEt-i6dFnAFw3R88JIOLAco6tHib4l2IeXAGf9V-_P8mz9GTTvtsX5zvGfpyvdovPxU3m4_r5eKmMFxVQyE56VqqdCchkEY0HaFaCaNMKTQrAVWtZa3WbVU2Eg4zLWXMVE0n2s4oPkNvTrqHFH-MNg9177Kx3utg45hrNaeUinIivv6LeB_HBD-Ua8bmnMuSTyR6IpkUc062qw_J9Toda0rqyez6ZHYNZteT2RBm6NVZeGx62z50nN0FAjsRMkABbH6Y_G_VPzHUuJg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>227335836</pqid></control><display><type>article</type><title>Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Harter, P. ; Hahmann, M. ; Lueck, H. J. ; Poelcher, M. ; Wimberger, P. ; Ortmann, O. ; Canzler, U. ; Richter, B. ; Wagner, U. ; Hasenburg, A. ; Burges, A. ; Loibl, S. ; Meier, W. ; Huober, J. ; Fink, D. ; Schroeder, W. ; Muenstedt, K. ; Schmalfeldt, B. ; Emons, G. ; du Bois, A.</creator><creatorcontrib>Harter, P. ; Hahmann, M. ; Lueck, H. J. ; Poelcher, M. ; Wimberger, P. ; Ortmann, O. ; Canzler, U. ; Richter, B. ; Wagner, U. ; Hasenburg, A. ; Burges, A. ; Loibl, S. ; Meier, W. ; Huober, J. ; Fink, D. ; Schroeder, W. ; Muenstedt, K. ; Schmalfeldt, B. ; Emons, G. ; du Bois, A.</creatorcontrib><description>Background
Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.
Methods
Exploratory analysis of the DESKTOP I trial (multicenter trial of patients undergoing surgery for recurrent ovarian cancer, 2000 to 2003).
Results
A total of 125 patients (50%) who underwent surgery for recurrent ovarian cancer had peritoneal carcinomatosis. Univariate analyses showed worse overall survival for patients with peritoneal carcinomatosis compared with patients without carcinomatosis (
P
< .0001). Patients with and without peritoneal carcinomatosis had a complete resection rate of 26% and 74%, respectively (
P
< .0001). This corresponded with the observation that patients with complete resection had a better prognosis than those with minimal residual disease of 1 to 5 mm, which commonly reflects peritoneal carcinomatosis (
P
= .0002). However, patients who underwent complete resection, despite peritoneal carcinomatosis, had a 2-year survival rate of 77%, which was similar to the 2-year survival rate of patients with completely debulked disease who did not have peritoneal carcinomatosis (81%) (
P
= .96). Analysis of prognostic factors did not show any independent effect of peritoneal carcinomatosis on survival in patients who underwent complete resection.
Conclusions
Peritoneal carcinomatosis was a negative predictor for complete resection but had no effect on prognosis if complete resection could be achieved. Improving surgical skills might be one step to increase the proportion of patients who might benefit from surgery for recurrent disease.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-009-0357-0</identifier><identifier>PMID: 19225844</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Databases as Topic ; Female ; Gynecologic Oncology ; Humans ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - surgery ; Oncology ; Ovarian cancer ; Ovarian Neoplasms - mortality ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - surgery ; Peritoneal Neoplasms - mortality ; Peritoneal Neoplasms - secondary ; Peritoneal Neoplasms - surgery ; Prognosis ; Risk Factors ; Surgery ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2009-05, Vol.16 (5), p.1324-1330</ispartof><rights>Society of Surgical Oncology 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-530fd16af516a0b4bf01a64c6c84a2830f6de2daad98b598b2cd122c9bf4dfc63</citedby><cites>FETCH-LOGICAL-c369t-530fd16af516a0b4bf01a64c6c84a2830f6de2daad98b598b2cd122c9bf4dfc63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-009-0357-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-009-0357-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19225844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harter, P.</creatorcontrib><creatorcontrib>Hahmann, M.</creatorcontrib><creatorcontrib>Lueck, H. J.</creatorcontrib><creatorcontrib>Poelcher, M.</creatorcontrib><creatorcontrib>Wimberger, P.</creatorcontrib><creatorcontrib>Ortmann, O.</creatorcontrib><creatorcontrib>Canzler, U.</creatorcontrib><creatorcontrib>Richter, B.</creatorcontrib><creatorcontrib>Wagner, U.</creatorcontrib><creatorcontrib>Hasenburg, A.</creatorcontrib><creatorcontrib>Burges, A.</creatorcontrib><creatorcontrib>Loibl, S.</creatorcontrib><creatorcontrib>Meier, W.</creatorcontrib><creatorcontrib>Huober, J.</creatorcontrib><creatorcontrib>Fink, D.</creatorcontrib><creatorcontrib>Schroeder, W.</creatorcontrib><creatorcontrib>Muenstedt, K.</creatorcontrib><creatorcontrib>Schmalfeldt, B.</creatorcontrib><creatorcontrib>Emons, G.</creatorcontrib><creatorcontrib>du Bois, A.</creatorcontrib><title>Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.
Methods
Exploratory analysis of the DESKTOP I trial (multicenter trial of patients undergoing surgery for recurrent ovarian cancer, 2000 to 2003).
Results
A total of 125 patients (50%) who underwent surgery for recurrent ovarian cancer had peritoneal carcinomatosis. Univariate analyses showed worse overall survival for patients with peritoneal carcinomatosis compared with patients without carcinomatosis (
P
< .0001). Patients with and without peritoneal carcinomatosis had a complete resection rate of 26% and 74%, respectively (
P
< .0001). This corresponded with the observation that patients with complete resection had a better prognosis than those with minimal residual disease of 1 to 5 mm, which commonly reflects peritoneal carcinomatosis (
P
= .0002). However, patients who underwent complete resection, despite peritoneal carcinomatosis, had a 2-year survival rate of 77%, which was similar to the 2-year survival rate of patients with completely debulked disease who did not have peritoneal carcinomatosis (81%) (
P
= .96). Analysis of prognostic factors did not show any independent effect of peritoneal carcinomatosis on survival in patients who underwent complete resection.
Conclusions
Peritoneal carcinomatosis was a negative predictor for complete resection but had no effect on prognosis if complete resection could be achieved. Improving surgical skills might be one step to increase the proportion of patients who might benefit from surgery for recurrent disease.</description><subject>Databases as Topic</subject><subject>Female</subject><subject>Gynecologic Oncology</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Oncology</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - mortality</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Ovarian Neoplasms - surgery</subject><subject>Peritoneal Neoplasms - mortality</subject><subject>Peritoneal Neoplasms - secondary</subject><subject>Peritoneal Neoplasms - surgery</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9UU2P0zAQtRCIXQo_gAuyOHAi4O8me6tKFypWatUtXCPHcRYvjl3sBNGfyT9iolZaCQkOHo_nvXkz8kPoJSXvKBPyfaZEcFEQUhWEy3lBHqFLKqEiVEkfQ05UWVRMyQv0LOd7QuicE_kUXdCKMVkKcYl-347pzqYj7mLCO2vGlGwY8OanTk4HvNTB2HSFd9FbHDu8tckNMVjtAUrGhdjrIWaXr_Dq18HHBC8QWwTtj1CdWoZvFn9Y3X7eb7Z4jfcg6_GiieOAdy5_x9faQEt-i6dFnAFw3R88JIOLAco6tHib4l2IeXAGf9V-_P8mz9GTTvtsX5zvGfpyvdovPxU3m4_r5eKmMFxVQyE56VqqdCchkEY0HaFaCaNMKTQrAVWtZa3WbVU2Eg4zLWXMVE0n2s4oPkNvTrqHFH-MNg9177Kx3utg45hrNaeUinIivv6LeB_HBD-Ua8bmnMuSTyR6IpkUc062qw_J9Toda0rqyez6ZHYNZteT2RBm6NVZeGx62z50nN0FAjsRMkABbH6Y_G_VPzHUuJg</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Harter, P.</creator><creator>Hahmann, M.</creator><creator>Lueck, H. 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J. ; Poelcher, M. ; Wimberger, P. ; Ortmann, O. ; Canzler, U. ; Richter, B. ; Wagner, U. ; Hasenburg, A. ; Burges, A. ; Loibl, S. ; Meier, W. ; Huober, J. ; Fink, D. ; Schroeder, W. ; Muenstedt, K. ; Schmalfeldt, B. ; Emons, G. ; du Bois, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-530fd16af516a0b4bf01a64c6c84a2830f6de2daad98b598b2cd122c9bf4dfc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Databases as Topic</topic><topic>Female</topic><topic>Gynecologic Oncology</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Oncology</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - mortality</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Ovarian Neoplasms - surgery</topic><topic>Peritoneal Neoplasms - mortality</topic><topic>Peritoneal Neoplasms - secondary</topic><topic>Peritoneal Neoplasms - surgery</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harter, P.</creatorcontrib><creatorcontrib>Hahmann, M.</creatorcontrib><creatorcontrib>Lueck, H. J.</creatorcontrib><creatorcontrib>Poelcher, M.</creatorcontrib><creatorcontrib>Wimberger, P.</creatorcontrib><creatorcontrib>Ortmann, O.</creatorcontrib><creatorcontrib>Canzler, U.</creatorcontrib><creatorcontrib>Richter, B.</creatorcontrib><creatorcontrib>Wagner, U.</creatorcontrib><creatorcontrib>Hasenburg, A.</creatorcontrib><creatorcontrib>Burges, A.</creatorcontrib><creatorcontrib>Loibl, S.</creatorcontrib><creatorcontrib>Meier, W.</creatorcontrib><creatorcontrib>Huober, J.</creatorcontrib><creatorcontrib>Fink, D.</creatorcontrib><creatorcontrib>Schroeder, W.</creatorcontrib><creatorcontrib>Muenstedt, K.</creatorcontrib><creatorcontrib>Schmalfeldt, B.</creatorcontrib><creatorcontrib>Emons, G.</creatorcontrib><creatorcontrib>du Bois, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harter, P.</au><au>Hahmann, M.</au><au>Lueck, H. J.</au><au>Poelcher, M.</au><au>Wimberger, P.</au><au>Ortmann, O.</au><au>Canzler, U.</au><au>Richter, B.</au><au>Wagner, U.</au><au>Hasenburg, A.</au><au>Burges, A.</au><au>Loibl, S.</au><au>Meier, W.</au><au>Huober, J.</au><au>Fink, D.</au><au>Schroeder, W.</au><au>Muenstedt, K.</au><au>Schmalfeldt, B.</au><au>Emons, G.</au><au>du Bois, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>16</volume><issue>5</issue><spage>1324</spage><epage>1330</epage><pages>1324-1330</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.
Methods
Exploratory analysis of the DESKTOP I trial (multicenter trial of patients undergoing surgery for recurrent ovarian cancer, 2000 to 2003).
Results
A total of 125 patients (50%) who underwent surgery for recurrent ovarian cancer had peritoneal carcinomatosis. Univariate analyses showed worse overall survival for patients with peritoneal carcinomatosis compared with patients without carcinomatosis (
P
< .0001). Patients with and without peritoneal carcinomatosis had a complete resection rate of 26% and 74%, respectively (
P
< .0001). This corresponded with the observation that patients with complete resection had a better prognosis than those with minimal residual disease of 1 to 5 mm, which commonly reflects peritoneal carcinomatosis (
P
= .0002). However, patients who underwent complete resection, despite peritoneal carcinomatosis, had a 2-year survival rate of 77%, which was similar to the 2-year survival rate of patients with completely debulked disease who did not have peritoneal carcinomatosis (81%) (
P
= .96). Analysis of prognostic factors did not show any independent effect of peritoneal carcinomatosis on survival in patients who underwent complete resection.
Conclusions
Peritoneal carcinomatosis was a negative predictor for complete resection but had no effect on prognosis if complete resection could be achieved. Improving surgical skills might be one step to increase the proportion of patients who might benefit from surgery for recurrent disease.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>19225844</pmid><doi>10.1245/s10434-009-0357-0</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2009-05, Vol.16 (5), p.1324-1330 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Databases as Topic Female Gynecologic Oncology Humans Medicine Medicine & Public Health Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - surgery Oncology Ovarian cancer Ovarian Neoplasms - mortality Ovarian Neoplasms - pathology Ovarian Neoplasms - surgery Peritoneal Neoplasms - mortality Peritoneal Neoplasms - secondary Peritoneal Neoplasms - surgery Prognosis Risk Factors Surgery Surgical Oncology |
| title | Surgery for Recurrent Ovarian Cancer: Role of Peritoneal Carcinomatosis: Exploratory Analysis of the DESKTOP I Trial About Risk Factors, Surgical Implications, and Prognostic Value of Peritoneal Carcinomatosis |
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