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Article: Chemical injuries from assaults: An increasing trend in a developing country.

Olaitan, Peter B / Jiburum, Bernard C

Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India

2009 Volume 41, Issue 1, Page(s) 20–23

Abstract: Objective: This paper describes chemical injuries, which presented to us and were managed at a burn unit in Nigeria. The purpose of this paper is to highlight the etiologies of these injuries, the extent of the injuries as well as to suggest possible ... ...

Abstract	Objective: This paper describes chemical injuries, which presented to us and were managed at a burn unit in Nigeria. The purpose of this paper is to highlight the etiologies of these injuries, the extent of the injuries as well as to suggest possible ways to prevent chemical injuries in our environment. Materials and methods: We carried out a retrospective review of chemical burns treated at our center. Our sources of information were the burn unit admission registers, case notes of the patients and operation registers. The results were collated and then analyzed. Results: Twenty eight patients presented with chemical burn injuries during the study period between January 2000 and December 2003, constituting 5.7% of all patients with burns treated within that period. Seventeen (60.7%) of the patients were males while 11 (29.3%) were females with a mean age of 20.6 years. The injuries were sustained from assault in 21 (75%), armed robbery attacks in five (17.8%) and suicide attempts in two (7.1%). The agents were usually unknown. Late presentation was observed in all the patients. Raw eggs, palm oil, gentian violet and engine oil were the substances applied immediately after the injuries. Complications observed included septicemia, respiratory distress, blindness, renal failure, mentosternal contractures, ectropion, axillary contractures, hypertrophic scars, keloids and skin depigmentation. Conclusion: Chemical burn injuries are mainly due to assaults in Nigeria and are usually extensive and presented late. Education of the people and penalty for any offender will reduce the current spate of such injuries.
Language	English
Publishing date	2009-06-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2118680-7
ISSN	1998-376X ; 0970-0358
ISSN (online)	1998-376X
ISSN	0970-0358
DOI	10.4103/0970-0358.41106
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Immunological insights into COVID-19 in Southern Nigeria.

Ugwu, Chinedu A / Alao, Oluwasina / John, Oluwagboadurami G / Akinnawo, Blossom / Ajayi, Israel / Odebode, Ooreofe / Bejide, Ifeoluwa / Campbell, Allan / Campbell, Julian / Adole, Jolly A / B Olawoye, Idowu / Akano, Kazeem / Okolie, Johnson / Eromon, Philomena / Olaitan, Peter / Olagunoye, Ajibola / Adebayo, Ibukun / Adebayo, Victor / Babalola, Elizabeth /

Abioye, Omowumi / Ajayi, Nnennaya / Ogah, Emeka / Ukwaja, Kingsley / Okoro, Sylvanus / Oje, Ogbonnaya / Kingsley, Ojide Chiedozie / Eke, Matthew / Onyia, Venatius / Achonduh-Atijegbe, Olivia / Ewah, Friday Elechi / Obasi, Mary / Igwe, Violet / Ayodeji, Olufemi / Chukwuyem, Abejegah / Owhin, Sampson / Oyejide, Nicholas / Abah, Sylvester / Ingbian, Winifred / Osoba, Moyosoore / Alebiosu, Ahmed / Nadesalingam, Angalee / Aguinam, Ernest T / Carnell, George / Krause, Nina / Chan, Andrew / George, Charlotte / Kinsley, Rebecca / Tonks, Paul / Temperton, Nigel / Heeney, Jonathan / Happi, Christian

Frontiers in immunology

2024 Volume 15, Page(s) 1305586

Abstract: Introduction: One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the ... ...

Abstract	Introduction: One of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic. Methods: We used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. Result: Our study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. Discussion: These findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.
MeSH term(s)	Humans ; Antibodies, Neutralizing ; Broadly Neutralizing Antibodies ; COVID-19/immunology ; Enzyme-Linked Immunospot Assay ; Immunoglobulin G ; Nigeria ; Pandemics ; SARS-CoV-2 ; West African People
Chemical Substances	Antibodies, Neutralizing ; Broadly Neutralizing Antibodies ; Immunoglobulin G
Language	English
Publishing date	2024-01-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2024.1305586
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Article ; Online: Recruitment of Yoruba families from Nigeria for genetic research: experience from a multisite keloid study.

Olaitan, Peter B / Odesina, Victoria / Ademola, Samuel / Fadiora, Solomon O / Oluwatosin, Odunayo M / Reichenberger, Ernst J

BMC medical ethics

2014 Volume 15, Page(s) 65

Abstract: Background: More involvement of sub-Saharan African countries in biomedical studies, specifically in genetic research, is needed to advance individualized medicine that will benefit non-European populations. Missing infrastructure, cultural and ... ...

Abstract	Background: More involvement of sub-Saharan African countries in biomedical studies, specifically in genetic research, is needed to advance individualized medicine that will benefit non-European populations. Missing infrastructure, cultural and religious beliefs as well as lack of understanding of research benefits can pose a challenge to recruitment. Here we describe recruitment efforts for a large genetic study requiring three-generation pedigrees within the Yoruba homelands of Nigeria. The aim of the study was to identify genes responsible for keloids, a wound healing disorder. We also discuss ethical and logistical considerations that we encountered in preparation for this research endeavor. Methods: Protocols for this bi-national intercultural study were approved by the Institutional Review Board (IRB) in the US and the ethics committees of the Nigerian institutions for consideration of cultural differences. Principles of community based participatory research were employed throughout the recruitment process. Keloid patients (patient advisors), community leaders, kings/chiefs and medical directors were engaged to assist the research teams with recruitment strategies. Community meetings, church forums, and media outlets (study flyers, radio and TV announcements) were utilized to promote the study in Nigeria. Recruitment of research participants was conducted by trained staff from the local communities. Pedigree structures were re-analyzed on a regular basis as new family members were recruited and recruitment challenges were documented. Results: Total recruitment surpassed 4200 study participants over a 7-year period including 79 families with complete three-generation pedigrees. In 9 families more than 20 family members participated, however, in 5 of these families, we encountered issues with pedigree structure as members from different branches presented inconsistent family histories. These issues were due to the traditional open family structure amongst the Yoruba and by beliefs in voodoo or in juju. In addition, family members living in other parts of the country or abroad complicated timely and complete family recruitment. Conclusions: Organizational, logistics and ethics challenges can be overcome by additional administrative efforts, good communication, community involvement and education of staff members. However, recruitment challenges due to infrastructural shortcomings or cultural and religious beliefs can lead to significant delays, which may negatively affect study time lines and expectations of funding agencies.
MeSH term(s)	African Continental Ancestry Group/genetics ; Community-Based Participatory Research/ethics ; Culture ; Ethics, Research ; Family ; Genetic Research/ethics ; Humans ; Keloid/genetics ; Nigeria ; Patient Selection/ethics ; Pedigree
Language	English
Publishing date	2014-09-02
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural
ZDB-ID	2041552-7
ISSN	1472-6939 ; 1472-6939
ISSN (online)	1472-6939
ISSN	1472-6939
DOI	10.1186/1472-6939-15-65
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Article: Chemical injuries from assaults: An increasing trend in a developing country

Olaitan, Peter B. / Jiburm, Bernard C

Indian Journal of Plastic Surgery

2008 Volume 41, Issue 01, Page(s) 20–23

Abstract	Objective: This paper describes chemical injuries, which presented to us and were managed at a burn unit in Nigeria. The purpose of this paper is to highlight the etiologies of these injuries, the extent of the injuries as well as to suggest possible ways to prevent chemical injuries in our environment. Materials and Methods: We carried out a retrospective review of chemical burns treated at our center. Our sources of information were the burn unit admission registers, case notes of the patients and operation registers. The results were collated and then analyzed. Results: Twenty eight patients presented with chemical burn injuries during the study period between January 2000 and December 2003, constituting 5.7% of all patients with burns treated within that period. Seventeen (60.7%) of the patients were males while 11 (29.3%) were females with a mean age of 20.6 years. The injuries were sustained from assault in 21 (75%), armed robbery attacks in five (17.8%) and suicide attempts in two (7.1%). The agents were usually unknown. Late presentation was observed in all the patients. Raw eggs, palm oil, gentian violet and engine oil were the substances applied immediately after the injuries. Complications observed included septicemia, respiratory distress, blindness, renal failure, mentosternal contractures, ectropion, axillary contractures, hypertrophic scars, keloids and skin depigmentation. Conclusion: Chemical burn injuries are mainly due to assaults in Nigeria and are usually extensive and presented late. Education of the people and penalty for any offender will reduce the current spate of such injuries.
Keywords	Assault ; chemical injuries ; Nigeria ; prevention
Language	English
Publishing date	2008-01-01
Publisher	Thieme Medical and Scientific Publishers Private Ltd.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2118680-7
ISSN	1998-376X ; 0970-0358
ISSN (online)	1998-376X
ISSN	0970-0358
DOI	10.1055/s-0039-1699222
Database	Thieme publisher's database

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Article ; Online: Honey: a reservoir for microorganisms and an inhibitory agent for microbes.

Olaitan, Peter B / Adeleke, Olufemi E / Ola, Iyabo O

African health sciences

2007 Volume 7, Issue 3, Page(s) 159–165

Abstract: Background: Honey is an ancient remedy for the treatment of infected wounds, which has recently been 'rediscovered' by the medical profession. The use to which honey is put in medical care is increasing daily with many authors pointing out its ... ...

Abstract	Background: Honey is an ancient remedy for the treatment of infected wounds, which has recently been 'rediscovered' by the medical profession. The use to which honey is put in medical care is increasing daily with many authors pointing out its importance and role in wound care. There have been reports that honey contains many microorganisms including bacteria and fungi. Objective: The aim of this paper is to highlight the various uses, organisms commonly found in honey, how the organisms arrived in the honey and their effects on wounds and wound care. Would the presence of these organisms not constitute a limiting factor to the use of honey in wound management? This is what this review aims to answer. Methods: A literature search was done on honey using pubmed, google, local books and journals. Relevant journals were extracted and discussed with emphasis on the antimicrobial properties as well as microbial content of honey and the implications of these. Results: The production of honey as well as the storing process account for the presence of microorganisims. Most of these organisms are said to be in inactive forms as they can hardly survive in honey because of its several properties including hygroscopicity, hyperosmolarity, acidity, peroxide content, antibiotic activities etc. However there is a need for caution in the use of honey in wound management. Conclusion: We suggest that wounds to be treated with honey should be investigated i.e with a swab for the microorganisms present on the wound and their sensitivity to the honey before commencing honey treatment. This will help in carefully selecting wounds that might do well with honey treatment not withstanding other properties of honey that aid wound healing.
MeSH term(s)	Anti-Infective Agents ; Bacteria/growth & development ; Complementary Therapies/methods ; Fungi/growth & development ; Honey/analysis ; Honey/microbiology ; Humans ; Wound Healing/physiology ; Wounds and Injuries/nursing
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2007-10-18
Publishing country	Uganda
Document type	Journal Article ; Review
ZDB-ID	2240308-5
ISSN	1729-0503 ; 1680-6905
ISSN (online)	1729-0503
ISSN	1680-6905
DOI	10.5555/afhs.2007.7.3.159
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Article ; Online: Quality of life of Nigerians living with human immunodeficiency virus.

Akinboro, Adeolu Oladayo / Akinyemi, Suliat Omolola / Olaitan, Peter B / Raji, Ajani Adeniyi / Popoola, Adetoun Adetayo / Awoyemi, Opeyemi Roseline / Ayodele, Olugbenga Edward

The Pan African medical journal

2014 Volume 18, Page(s) 234

Abstract: Introduction: Few reports from Nigeria have examined the quality of life (QOL) of people living with HIV/AIDS (PLWHA) despite the fact that Nigeria has the second largest number of PLWHA in the world. This study evaluated the QOL of Nigerians living ... ...

Abstract	Introduction: Few reports from Nigeria have examined the quality of life (QOL) of people living with HIV/AIDS (PLWHA) despite the fact that Nigeria has the second largest number of PLWHA in the world. This study evaluated the QOL of Nigerians living with HIV/AIDS using the World Health Organization Quality of Life Questionnaire for HIV-Brief Version (WHOQOL-BREF) instrument and assessed the impact of demographic, laboratory and disease-related variables on QOL. Methods: This cross-sectional study involved 491 consecutive PLWHA aged ≥ 18 years attending the dedicated clinic to PLWHA in South-west Nigeria. Results: The lowest mean QOL scores were recorded in the environment and social domains. Participants aged ≥ 40 years had better QOL in the environment (p = 0.039) and spirituality (p = 0.033) domains and those in relationships had better QOL in the social relationship domain (p = 0.002). Subjects with no or primary education and those who rated their health status as good gave significantly higher ratings in all QOL domains. Participants with AIDS had significant lower QOL in the level of independence domain (p = 0.018) and those with CD4 count ≥ 350 cells /mm3 had better QOL scores in the physical, psychological and level of independence domains. Subjects without tuberculosis co-infection and those on antiretroviral therapy (ART) reported significantly better QOL in the physical, psychological, level of independence and spirituality domains. Conclusion: Marital relationship, absence of tuberculosis, CD4 count ≥ 350 cells /mm3 and use of ART positively impacted QOL of our patients.
MeSH term(s)	Adult ; Age Factors ; Anti-Retroviral Agents/therapeutic use ; CD4 Lymphocyte Count ; Cross-Sectional Studies ; Female ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/psychology ; Health Status ; Humans ; Male ; Marital Status ; Nigeria/epidemiology ; Quality of Life ; Surveys and Questionnaires
Chemical Substances	Anti-Retroviral Agents
Language	English
Publishing date	2014
Publishing country	Uganda
Document type	Journal Article
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2014.18.234.2816
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Article: Inhibitory activities of omega-3 Fatty acids and traditional african remedies on keloid fibroblasts.

Olaitan, Peter B / Chen, I-Ping / Norris, James E C / Feinn, Richard / Oluwatosin, Odunayo M / Reichenberger, Ernst J

Wounds : a compendium of clinical research and practice

2013 Volume 23, Issue 4, Page(s) 97–106

Abstract: Keloids develop when scar tissue responds to skin trauma with proliferative fibrous growths that extend beyond the boundaries of the original wound and progress for several months or years. Keloids most frequently occur in individuals of indigenous sub- ... ...

Abstract	Keloids develop when scar tissue responds to skin trauma with proliferative fibrous growths that extend beyond the boundaries of the original wound and progress for several months or years. Keloids most frequently occur in individuals of indigenous sub-Saharan African origin. The etiology for keloids is still unknown and treatment can be problematic as patients respond differently to various treatment modalities. Keloids have a high rate of recurrence following surgical excision. Some West African patients claim to have had successful outcomes with traditional African remedies-boa constrictor oil (BCO) and shea butter-leading the authors to investigate their effects on cultured fibroblasts. The effects of emulsions of BCO, fish oil, isolated omega-3 fatty acids, and shea butter were tested in comparison to triamcinolone regarding inhibition of cell growth in keloid and control fibroblast cultures. In a series of controlled studies, it was observed that fish oil and BCO were more effective than triamcinolone, and that cis-5, 8, 11, 14, 17-eicosapentaenoic acid was more effective than -linolenic acid. While cell counts in control cultures continuously decreased over a period of 5 days, cell counts in keloid cultures consistently declined between day 1 and day 3, and then increased between day 3 and day 5 for all tested reagents except for fish oil. These results suggest that oils rich in omega-3 fatty acids may be effective in reducing actively proliferating keloid fibroblasts. Additional studies are warranted to investigate whether oils rich in omega-3 fatty acids offer effective and affordable treatment for some keloid patients, especially in the developing world.
Language	English
Publishing date	2013-12-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1214936-6
ISSN	1044-7946
ISSN	1044-7946
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Article ; Online: The demise of islet allotransplantation in the United States: A call for an urgent regulatory update.

Witkowski, Piotr / Philipson, Louis H / Kaufman, Dixon B / Ratner, Lloyd E / Abouljoud, Marwan S / Bellin, Melena D / Buse, John B / Kandeel, Fouad / Stock, Peter G / Mulligan, David C / Markmann, James F / Kozlowski, Tomasz / Andreoni, Kenneth A / Alejandro, Rodolfo / Baidal, David A / Hardy, Mark A / Wickrema, Amittha / Mirmira, Raghavendra G / Fung, John /

Becker, Yolanda T / Josephson, Michelle A / Bachul, Piotr J / Pyda, Jordan S / Charlton, Michael / Millis, J Michael / Gaglia, Jason L / Stratta, Robert J / Fridell, Jonathan A / Niederhaus, Silke V / Forbes, Rachael C / Jayant, Kumar / Robertson, R Paul / Odorico, Jon S / Levy, Marlon F / Harland, Robert C / Abrams, Peter L / Olaitan, Oyedolamu K / Kandaswamy, Raja / Wellen, Jason R / Japour, Anthony J / Desai, Chirag S / Naziruddin, Bashoo / Balamurugan, Appakalai N / Barth, Rolf N / Ricordi, Camillo

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

2021 Volume 21, Issue 4, Page(s) 1365–1375

Abstract: Islet allotransplantation in the United States (US) is facing an imminent demise. Despite nearly three decades of progress in the field, an archaic regulatory framework has stymied US clinical practice. Current regulations do not reflect the state-of-the- ...

Abstract	Islet allotransplantation in the United States (US) is facing an imminent demise. Despite nearly three decades of progress in the field, an archaic regulatory framework has stymied US clinical practice. Current regulations do not reflect the state-of-the-art in clinical or technical practices. In the US, islets are considered biologic drugs and "more than minimally manipulated" human cell and tissue products (HCT/Ps). In contrast, across the world, human islets are appropriately defined as "minimally manipulated tissue" and not regulated as a drug, which has led to islet allotransplantation (allo-ITx) becoming a standard-of-care procedure for selected patients with type 1 diabetes mellitus. This regulatory distinction impedes patient access to islets for transplantation in the US. As a result only 11 patients underwent allo-ITx in the US between 2016 and 2019, and all as investigational procedures in the settings of a clinical trials. Herein, we describe the current regulations pertaining to islet transplantation in the United States. We explore the progress which has been made in the field and demonstrate why the regulatory framework must be updated to both better reflect our current clinical practice and to deal with upcoming challenges. We propose specific updates to current regulations which are required for the renaissance of ethical, safe, effective, and affordable allo-ITx in the United States.
MeSH term(s)	Biological Products ; Costs and Cost Analysis ; Diabetes Mellitus, Type 1/surgery ; Humans ; Islets of Langerhans Transplantation ; Transplantation, Heterologous ; United States
Chemical Substances	Biological Products
Language	English
Publishing date	2021-02-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2060594-8
ISSN	1600-6143 ; 1600-6135
ISSN (online)	1600-6143
ISSN	1600-6135
DOI	10.1111/ajt.16397
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Article ; Online: Identification of ASAH1 as a susceptibility gene for familial keloids.

Santos-Cortez, Regie Lyn P / Hu, Ying / Sun, Fanyue / Benahmed-Miniuk, Fairouz / Tao, Jian / Kanaujiya, Jitendra K / Ademola, Samuel / Fadiora, Solomon / Odesina, Victoria / Nickerson, Deborah A / Bamshad, Michael J / Olaitan, Peter B / Oluwatosin, Odunayo M / Leal, Suzanne M / Reichenberger, Ernst J

European journal of human genetics : EJHG

2017 Volume 25, Issue 10, Page(s) 1155–1161

Abstract: Keloids result from abnormal proliferative scar formation with scar tissue expanding beyond the margin of the original wound and are mostly found in individuals of sub-Saharan African descent. The etiology of keloids has not been resolved but previous ... ...

Abstract	Keloids result from abnormal proliferative scar formation with scar tissue expanding beyond the margin of the original wound and are mostly found in individuals of sub-Saharan African descent. The etiology of keloids has not been resolved but previous studies suggest that keloids are a genetically heterogeneous disorder. Although possible candidate genes have been suggested by genome-wide association studies using common variants, by upregulation in keloids or their involvement in syndromes that include keloid formation, rare coding variants that contribute to susceptibility in non-syndromic keloid formation have not been previously identified. Through analysis of whole-genome data we mapped a locus to chromosome 8p23.3-p21.3 with a statistically significant maximum multipoint LOD score of 4.48. This finding was followed up using exome sequencing and led to the identification of a c.1202T>C (p.(Leu401Pro)) variant in the N-acylsphingosine amidohydrolase (ASAH1) gene that co-segregates with the keloid phenotype in a large Yoruba family. ASAH1 is an acid ceramidase known to be involved in tumor formation by controlling the ratio of ceramide and sphingosine. ASAH1 is also involved in cell proliferation and inflammation, and may affect the development of keloids via multiple mechanisms. Functional studies need to clarify the role of the ASAH1 variant in wound healing.
MeSH term(s)	Acid Ceramidase/genetics ; Adult ; Female ; Humans ; Keloid/diagnosis ; Keloid/genetics ; Male ; Mutation, Missense ; Pedigree
Chemical Substances	ASAH1 protein, human (EC 3.5.1.23) ; Acid Ceramidase (EC 3.5.1.23)
Language	English
Publishing date	2017-07-26
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1141470-4
ISSN	1476-5438 ; 1018-4813
ISSN (online)	1476-5438
ISSN	1018-4813
DOI	10.1038/ejhg.2017.121
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Article ; Online: Randomized Trial of Cytoreductive Surgery for Relapsed Ovarian Cancer.

Harter, Philipp / Sehouli, Jalid / Vergote, Ignace / Ferron, Gwenael / Reuss, Alexander / Meier, Werner / Greggi, Stefano / Mosgaard, Berit J / Selle, Frederic / Guyon, Frédéric / Pomel, Christophe / Lécuru, Fabrice / Zang, Rongyu / Avall-Lundqvist, Elisabeth / Kim, Jae-Weon / Ponce, Jordi / Raspagliesi, Francesco / Kristensen, Gunnar / Classe, Jean-Marc /

Hillemanns, Peter / Jensen, Pernille / Hasenburg, Annette / Ghaem-Maghami, Sadaf / Mirza, Mansoor R / Lund, Bente / Reinthaller, Alexander / Santaballa, Ana / Olaitan, Adeola / Hilpert, Felix / du Bois, Andreas

The New England journal of medicine

2022 Volume 385, Issue 23, Page(s) 2123–2131

Abstract: Background: Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear.: Methods: We randomly assigned patients with recurrent ovarian cancer who had a first ... ...

Abstract	Background: Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. Methods: We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during which no platinum-based chemotherapy was used) of 6 months or more to undergo secondary cytoreductive surgery and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Patients were eligible if they presented with a positive Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) score, defined as an Eastern Cooperative Oncology Group performance-status score of 0 (on a 5-point scale, with higher scores indicating greater disability), ascites of less than 500 ml, and complete resection at initial surgery. A positive AGO score is used to identify patients in whom a complete resection might be achieved. The primary end point was overall survival. We also assessed quality of life and prognostic factors for survival. Results: A total of 407 patients underwent randomization: 206 were assigned to cytoreductive surgery and chemotherapy, and 201 to chemotherapy alone. A complete resection was achieved in 75.5% of the patients in the surgery group who underwent the procedure. The median overall survival was 53.7 months in the surgery group and 46.0 months in the no-surgery group (hazard ratio for death, 0.75; 95% confidence interval, 0.59 to 0.96; P = 0.02). Patients with a complete resection had the most favorable outcome, with a median overall survival of 61.9 months. A benefit from surgery was seen in all analyses in subgroups according to prognostic factors. Quality-of-life measures through 1 year of follow-up did not differ between the two groups, and we observed no perioperative mortality within 30 days after surgery. Conclusions: In women with recurrent ovarian cancer, cytoreductive surgery followed by chemotherapy resulted in longer overall survival than chemotherapy alone. (Funded by the AGO Study Group and others; DESKTOP III ClinicalTrials.gov number, NCT01166737.).
MeSH term(s)	Aged ; Antineoplastic Agents/therapeutic use ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Female ; Humans ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/surgery ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/surgery ; Proportional Hazards Models ; Quality of Life ; Survival Analysis
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMoa2103294
Database	MEDical Literature Analysis and Retrieval System OnLINE

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