Chirurgie initiale ou d'intervalle dans les cancers de l'ovaire de stade avancé ? État de la question en 2004 et critères de sélection des patientes

Morice, Philippe; Leblanc, Éric; Narducci, Fabrice; Pomel, Christophe; Pautier, Patricia; Chevalier, A.; Lhommé, C.; Castaigne, Damienne

doi:10.1016/j.gyobfe.2004.11.010

Cited by 4 publications

(3 citation statements)

References 50 publications

(57 reference statements)

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“…Among these cases, there is a risk of false positives: resectable patients evaluated as unresectable by laparoscopy, addressed to neoadjuvant chemotherapy instead of surgery. In order to reduce these misclassifications, we used reliable and robust criteria to assess unresectability [ 11 ]. In laparoscopy, moreover, false-positives are rare.…”

Section: Discussionmentioning

confidence: 99%

“…Cytoreductive surgery was deemed contraindicated in patients with any of the following laparoscopy criteria: massive involvement of the hepatic pedicle, bowel involvement requiring extensive small-bowel resection, the need for more than two gastrointestinal resections and/or mesenteric resection, suprarenal lymphadenopathy, and massive involvement of the retroperitoneum [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A pre-operative predictive score to evaluate the feasibility of complete cytoreductive surgery in patients with epithelial ovarian cancer

Chesnais¹,

Lécuru²,

Mimouni³

et al. 2017

PLoS ONE

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ObjectivePostoperative residual tumor is the major prognostic factor in ovarian cancer. The feasibility of complete cytoreductive surgery is assessed by laparoscopy. Our goal was to develop a predictive score prior to laparoscopy to evaluate the feasibility of complete cytoreductive surgery in patients with epithelial ovarian cancer.MethodsWe developed a score to predict incomplete cytoreductive surgery by performing multiple logistic regressions after bootstrap procedures on data from a retrospective cohort of 247 patients with advanced ovarian cancer. This score was validated on a different population of 45 patients with ovarian cancer.ResultsFour criteria were independently associated with incomplete cytoreduction, confirmed by surgery: BMI ≥ 30 kg/m2 (adjusted odds ratio [aOR], 3.07; 95% confidence interval [95% CI], 1.0–9.6), CA125 > 100 IU/L (aOR, 3.99; 95% CI, 1.6–10.1), diaphragmatic and/or omental carcinomatosis by CT-Scan (aOR, 5.82; 95% CI, 2.6–13.1), and positive parenchymal metastases by PET/CT (aOR, 3.59; 95% CI, 1.0–12.8). The 100-point score was based on these criteria. The area-under-the-curve of the score was 0.79 (95% CI, 0.73–0.86). In the validation group, no patient ranked in the high-risk group of incomplete cytoreductive surgery had a complete upfront cytoreductive surgery (95% CI 0–16). Three of 29 patients for whom primary complete cytoreduction was not possible were classified in the group at low risk of incomplete cytoreductive surgery (12%; 95% CI 4–27).ConclusionThis pre-operative score may be useful for distinguishing which patients may have complete cytoreductive surgery from those who will receive neoadjuvant chemotherapy, while avoiding unnecessary laparoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A pre-operative predictive score to evaluate the feasibility of complete cytoreductive surgery in patients with epithelial ovarian cancer

Chesnais¹,

Lécuru²,

Mimouni³

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…En fait, la notion de la chirurgie optimale a beaucoup évolué dans le temps et varie dans la littérature de 0,5 à 2 cm. Actuellement, il est admis une taille résiduelle tumorale de 1 cm [15][16][17][18]. Cette chirurgie optimale dépend du stade mais aussi de la formation et de l'expérience du chirurgien.…”

Section: Diagnosticunclassified

Prise en charge diagnostique et thérapeutique des tumeurs épithéliales malignes de l’ovaire dans le centre ouest-africain de lutte contre le cancer de Dakar

Dem

Dieng

et al. 2013

Bulletin du Cancer

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Cancer avancé de l'ovaire, un traitement chirurgical optimal est possible pour toutes les patientes grâce à la cœlioscopie

Canis

Jardon

Rabischong

et al. 2006

Annales de Chirurgie

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Chirurgie initiale ou d'intervalle dans les cancers de l'ovaire de stade avancé ? État de la question en 2004 et critères de sélection des patientes

Cited by 4 publications

References 50 publications

A pre-operative predictive score to evaluate the feasibility of complete cytoreductive surgery in patients with epithelial ovarian cancer

A pre-operative predictive score to evaluate the feasibility of complete cytoreductive surgery in patients with epithelial ovarian cancer

Prise en charge diagnostique et thérapeutique des tumeurs épithéliales malignes de l’ovaire dans le centre ouest-africain de lutte contre le cancer de Dakar

Cancer avancé de l'ovaire, un traitement chirurgical optimal est possible pour toutes les patientes grâce à la cœlioscopie

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