RESUMEN
Estrogens play the most important role in breast cancer oncogenesis. There are different methods used to decrease estrogen production and serum concentration: surgery, irradiation and drug-based method. In the current study 500 patients with localized surgically resectable breast cancer (infiltrative-edematous form included) or disseminated breast cancer with indication for ovarial function inhibition. The patients were divided into 3 groups. The first group consisted of 400 patients with prior endoscopic bilateral ovariectomy. The second group included 50 patients with prior ovarian irradiation, the third one included 50 patients after laparotomic ovarian resection. The results obtained show 100% effect of endoscopic ovariectomy resulted in disabled ovarian function, which is more effective, than ovarian irradiation (92%). Besides, the endoscopic method doesn't have negative effects characteristic for irradiation, such as involvement of non-target organs or restoration of hormone production. Endoscopic surgery was characterized by 10-fold decrease in complications rate compared to laparotomic operation (2.2% vs 24%). Besides, endoscopic intervention leads to much shorter inpatient treatment duration and demand for anesthetics and antibiotic treatment making it less costly, than more traditional methods of castration. Therefore, endoscopic ovarian resection is a safe and effective castration method in breast cancer patients.
Asunto(s)
Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/terapia , Estrógenos/biosíntesis , Neoplasias Hormono-Dependientes/metabolismo , Neoplasias Hormono-Dependientes/terapia , Ovariectomía , Ovario/efectos de la radiación , Adulto , Neoplasias de la Mama/sangre , Neoplasias de la Mama/radioterapia , Endoscopía , Estrógenos/sangre , Femenino , Humanos , Laparotomía , Persona de Mediana Edad , Neoplasias Hormono-Dependientes/sangre , Neoplasias Hormono-Dependientes/radioterapia , Ovariectomía/métodos , Ovario/metabolismo , Premenopausia , Estudios RetrospectivosRESUMEN
A residual tumor after primary cytoreductive surgery is one of the most important factors of survival of patient with advanced ovarian cancer. Maximal cytoreduction can be achieved by different ways. We studied results of extended, combined and standard operations on patients treated in the Russian Cancer Research Center of the Russian Academy of Medical Sciences in 1989-1999. It was found that only optimal cytoreduction resulted in the absence of recurrences and better overall survival of the patients independent of the operation type (extended, combined or standard).
