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Review
. 2020 Nov 30;13(1):141.
doi: 10.1186/s13048-020-00744-2.

Improved prognosis for recurrent epithelial ovarian cancer by early diagnosis and 125I seeds implantation during suboptimal secondary cytoreductive surgery: a case report and literature review

Lin Xiao  1 , Junying Tang  2 , Wenbo Li  3 , Xuexun Xu  2 , Hao Zhang  2
Affiliations
Review

Improved prognosis for recurrent epithelial ovarian cancer by early diagnosis and 125I seeds implantation during suboptimal secondary cytoreductive surgery: a case report and literature review

Lin Xiao et al. J Ovarian Res. .

Abstract

Background: Epithelial ovarian cancer (EOC) has the worst prognosis in all of gynecologic malignant tumors because of its high recurrence and eventually chemo-resistance. Early diagnosis of recurrence is crucial to avoid diffuse dissemination. Failure of traditional treatment in recurrent epithelial ovarian cancer remains a challenge for clinicians. On the other hand, 125I brachytherapy has been accepted as a useful and hopeful treatment for multiple advanced cancers in recent years. However, its success in advanced epithelial ovarian cancer is limited. Here we report a case of recurrent ovarian cancer who had been early diagnosis of isolated recurrence and successfully treated with 125I seeds implantation during suboptimal cytoreductive surgery.

Case presentation: A 59-year-old woman presented with recurrent epithelial ovarian cancer who have had a history of ovarian cancer stage IIIB and an R0 resection had been achieved nearly 2 years before presented in our hospital. She underwent suboptimal secondary cytoreductive surgery after four cycles of chemotherapy with little effectiveness and severe chemotherapy-related side effects. Approximately 70% of the cancer-bulk was resected during surgery. For residual lesion which fixed around the right ureter and right external iliac vessel, 125I seeds implantation was performed. Postoperatively, the patient was treated with two cycles of combination chemotherapy with paclitaxel and carboplatin. The patient was free of disease at 26 months' follow-up period.

Conclusion: In recurrent EOC patients with unresectable isolated lesion, salvage 125I seeds implantation are feasible and may contribute to survival.

Keywords: 125I seeds implantation; Recurrent epithelial ovarian cancer; Secondary cytoreductive surgery.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Timeline showing CA125 and HE4 levels after primary cytoreductive surgery
Fig. 2
Fig. 2
Recurrent lesion: a PET-CT lesion recurred from ovarian cancer at right pelvic cavity. b Mild hydronephrosis. c MRI lesion recurred from ovarian cancer after four cycles of chemotherapy
Fig. 3
Fig. 3
Timeline showing CA125 and HE4 levels after second cytoreductive surgery and seeding implantation
Fig. 4
Fig. 4
Postoperative image in June 2019: a. MRI showed no obvious local lesion. b. CT showed tumor disappeared, with only radioactive seeds remaining
See this image and copyright information in PMC

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