Abdominopelvic cytoreduction rates and recurrence sites in stage IV ovarian cancer: Is there a case for thoracic cytoreduction?

Perri, Tamar; Ben‐Baruch, Gilad; Kalfon, Sarit; Beiner, Mario; Helpman, Limor; Hogen, Liat; Korach, Jacob

doi:10.1016/j.ygyno.2013.07.093

Cited by 22 publications

(15 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with liver metastasis at initial diagnosis carried a high risk of recurrent disease involving the liver but also showed a high risk of intra-peritoneal recurrence (58%). Similar results are reported by Perri et al [85] were the majority of recurrence in initial stage IV patients were seen intraabdominally.…”

Section: Surveillancesupporting

confidence: 90%

FIGO stage IV epithelial ovarian, fallopian tube and peritoneal cancer revisited

Ataseven

Chiva

Harter

et al. 2016

Gynecologic Oncology

View full text Add to dashboard Cite

Section: Surveillancesupporting

confidence: 90%

FIGO stage IV epithelial ovarian, fallopian tube and peritoneal cancer revisited

Ataseven

Chiva

Harter

et al. 2016

Gynecologic Oncology

View full text Add to dashboard Cite

“…Within the thorax itself, patients with pre-operative abnormal cardiophrenic lymph nodes were found to have recurrent disease at many sites, not restricted to the nodal basin. Among these patients, the predominant disease site was the pleura, including pleural effusions11 and significant overlap was noted with other thoracic sites, including the lung parenchyma or posterior mediastinal, subcarinal, internal mammary or axillary nodes,6 and effusions of the pericardium 3…”

Section: Resultsmentioning

confidence: 99%

“…Recurrence sites of epithelial ovarian cancer have long been thought to be influenced by stage, initial disease sites, operative interventions, grade, and individual histologic subtypes 1–3. Cardiophrenic lymph nodes represent a common site of both pre-operative and recurrent metastatic disease, and enlargement may be detected in pre-operative imaging in up to 28% of patients with advanced epithelial ovarian cancer 4.…”

Section: Introductionmentioning

confidence: 99%

Recurrence patterns in patients with abnormal cardiophrenic lymph nodes at ovarian cancer diagnosis

Larish

Mert

McGree

et al. 2020

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectivesMetastases in cardiophrenic lymph nodes noted at diagnosis of epithelial ovarian cancer confer a poor prognosis. It is unclear if cardiophrenic nodal metastases portend an atypical pattern of recurrence. We report on patients with radiographically involved cardiophrenic lymph nodes who underwent optimal primary debulking surgery to describe patterns of recurrence and response to chemotherapy.MethodsPatients undergoing primary debulking surgery for stage IIIC/IV epithelial ovarian carcinoma with residual disease ≤1.0 cm at our institution from 2003 to 2011 with a pre-operative computed tomography (CT) scan were identified. Scans were reviewed by blinded radiologists, who identified abnormal cardiophrenic lymph nodes via a qualitative assessment scale based on size, heterogeneity, and architecture.ResultsOf the 250 patients identified, a recurrence site was documented in 22/27 (81.5%) with abnormal pre-operative cardiophrenic lymph nodes (defined by an elevated Qualitative Assessment Scale (QAS) score of ≥4), and in 128/223 (57.4%) without abnormal pre-operative cardiophrenic lymph nodes. Median short axis and long axis lymph node diameters for these patients was 9 (range 6–15) mm and 15 (range 11–22) mm, respectively. Cardiophrenic lymph nodes were resected in one patient. Patients with abnormal cardiophrenic nodes are more likely to have synchronous recurrence in thorax/pelvis and abdomen (50.0% (11/22) vs 25.0% (32/128), p=0.02) and less likely to have isolated recurrence in pelvis or abdomen (40.9% (9/22) vs 68.0% (87/128)). All patients who had a CT scan after six cycles of chemotherapy had improvement (defined as reduction of QAS score) in cardiophrenic lymphadenopathy.ConclusionsDespite cardiophrenic adenopathy demonstrating a complete radiographic response to chemotherapy, their presence pre-operatively is associated with an increased risk of recurrence in the thorax. Knowledge of this propensity to recur in the thorax is important to ensure all extra-abdominal recurrence sites are diagnosed and managed appropriately.

show abstract

“…In other words, there is not enough evidence in the literature to suggest that an aggressive cytoreduction of pleural disease ultimately translates to improved outcomes. In a study by Perri et al, 18 the authors sought to determine the impact of thoracic cytoreduction in patients with stage IV ovarian cancer. The authors compared a group of patients with stage IV ovarian, fallopian tube, or primary peritoneal cancer who had cytoreductive surgery either upfront or after neoadjuvant chemotherapy (group 1) to a group of patients with stage IIIC that underwent a similar approach (cytoreductive surgery or neoadjuvant chemotherapy) (group 2).…”

Section: Discussionmentioning

confidence: 99%

Role of Video-Assisted Thoracoscopy in Advanced Ovarian Cancer: A Literature Review

Guilmi

Salvo

Mehran

et al. 2016

Int J Gynecol Cancer

View full text Add to dashboard Cite

Tools that accurately predict the presence of metastatic ovarian cancer in the pleura are limited. Thus, we sought to summarize the current literature on video-assisted thoracoscopic surgery (VATS) and its applicability in patients with advanced ovarian cancer. A total of 187 patients with suspected ovarian cancer who underwent the VATS procedure were identified for this analysis. The median patient age was 59.4 years (range, 20.3-83 years). The median operative time for VATS was 32 minutes (range, 5-65 minutes). In 89 patients (48%), VATS revealed macroscopic disease in the pleural cavity. After VATS, 44 patients underwent neoadjuvant chemotherapy, and the remaining 143 patients underwent primary cytoreductive surgery. Video-assisted thoracoscopic surgery led to a change in disease stage or management in 76 patients (41%). Among patients with pleural effusions, VATS revealed pleural disease in 57% of patients, and 73% of patients with positive pleural cytology had evidence of pleural disease at the time of VATS. In addition, 23.5% of patients with negative pleural cytology had evidence of pleural disease at the time of VATS. Prospective trials are needed to accurately evaluate the impact of VATS on disease-free and overall survival in patients with advanced ovarian cancer. Video-assisted thoracoscopic surgery can help determine which patients are ideal candidates for surgical cytoreduction.

show abstract

Abdominopelvic cytoreduction rates and recurrence sites in stage IV ovarian cancer: Is there a case for thoracic cytoreduction?

Cited by 22 publications

References 31 publications

FIGO stage IV epithelial ovarian, fallopian tube and peritoneal cancer revisited

FIGO stage IV epithelial ovarian, fallopian tube and peritoneal cancer revisited

Recurrence patterns in patients with abnormal cardiophrenic lymph nodes at ovarian cancer diagnosis

Role of Video-Assisted Thoracoscopy in Advanced Ovarian Cancer: A Literature Review

Contact Info

Product

Resources

About