Clinical Outcome After Completion Surgery in Patients With Ovarian Cancer: The Charite Experience

Babayeva, Aygun; Braicu, Elena Ioana; Grabowski, Jacek; Gasimli, Khayal; Richter, Rolf; Muallem, Mustafa Zelal; Sehouli, Jalid

doi:10.1097/igc.0000000000001328

Cited by 9 publications

(7 citation statements)

References 30 publications

(22 reference statements)

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“…If preoperative CT-PCI could mimic the operative S-PCI, it would be an excellent tool for assessing the resectability of a tumor, since S-PCI is a good indicator of OS, [4,19]. In the present study, CCS resulted in a signi cantly longer OS compared with patients with residual disease < 10 mm and those with suboptimal debulking (residual disease ≥ 10 mm), in line with previous studies [5,11]. This study intended to elucidate whether patients with residual disease over 10 mm could be identi ed preoperatively, since CT-PCI correlated with intraoperative PCI (S-PCI).…”

Section: Discussionsupporting

confidence: 88%

The role of computed tomography in predicting peritoneal carcinomatosis and upfront surgery outcome in advanced ovarian cancer

M¹,

Malander²,

Wallengren³

et al. 2020

Preprint

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Background Epithelial ovarian cancer is usually diagnosed at advanced stages. To choose the best therapeutic approach, an accurate assessment of the tumor spread is crucial. This study aimed to determine whether numeric scoring, the amount of ascites, and the presence of cardiophrenic nodes (CPLNs) visualized by computed tomography (CT), can predict the tumor extent and improve the outcome of AOC upfront surgery. Methods This single center retrospective analysis of 194 patients diagnosed with AOC included 119 patients treated with upfront surgery at the Skåne University Hospital, Lund, Sweden, from January 2016 to December 2018. CT based peritoneal cancer index (PCI) scores, enlarged cardiophrenic lymph nodes (CPLNs), and the amount of ascites were correlated to the surgical PCI (S-PCI) and the completeness of the cytoreductive surgery.The patients were grouped according to the residual disease (RD) and the overall survival (OS) rates for the three groups were determined using Kaplan-Meier curves. Linear regression and the interclass correlation (ICC) analyses were used to determine the relationship between CT-PCI and S-PCI. Results The survival rate was significantly higher in patients with no macroscopic residual disease compared those with residual disease <10 mm (p<0.03) or residual disease ≥10 mm (p<0.005). S-PCI and large ascites volumes were correlated with the risk of suboptimal residual disease (for ascites > 1000 ml, OR 5.5626 (1.665-19.007) p<0.019; for S-PCI, OR 1.24 (1.141-1.348), p<0.001). CT-PCI, CA-125 level and CPLN were not predictive of the cytoreductive surgery results in the adjusted data to days from CT to operation and for ascites. CT-PCI correlated well to S-PCI ((95%) CI: 0.397 (0.252-0.541) p<0.001). Conclusions CT is a reliable tool for assessing the extent of the disease in AOC, but it has limitations in predicting surgical outcome. This study was unable to show an association between the CT-PCI and surgical outcome when the data were adjusted and ascites, CA-125 level, days between the CT examination to surgery and CPLN. Ascites volumes exceeding 1000 ml increased the risk of residual disease and thereby worse outcome. That certain areas (e.g., small bowel region) are particularly critical when evaluating surgical outcome using preoperative CT-PCI warrants further investigation.

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Section: Discussionsupporting

confidence: 88%

The role of computed tomography in predicting peritoneal carcinomatosis and upfront surgery outcome in advanced ovarian cancer

M¹,

Malander²,

Wallengren³

et al. 2020

Preprint

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“…In patients undergoing USO or BSO, comprehensive surgical staging should still be performed in most patients to rule out occult higher-stage disease, because data show that approximately 30% of patients (with presumed early-stage disease) are upstaged after undergoing complete staging surgery. 23,27,28,[112][113][114][115][116] Comprehensive surgical staging may be omitted in pediatric/ adolescent patients with clinically apparent early-stage malignant germ cell tumors based on the pediatric surgical literature suggesting that incomplete staging does not result in poorer outcomes (OS). 117 For adults with apparent stage I malignant ovarian germ cell tumors, comprehensive staging is recommended based on results from retrospective studies suggesting that incomplete surgical staging may be associated with increased risk of recurrence 118,119 ; although others found no relationship between incomplete staging and DFS.…”

Section: Fertility Sparing Options For Stage I Diseasementioning

confidence: 99%

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Armstrong

Alvarez

Bakkum-Gamez³

et al. 2021

Journal of the National Comprehensive Cancer Network

451

356

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Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States and is the country’s fifth most common cause of cancer mortality in women. A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. These NCCN Guidelines discuss cancers originating in the ovary, fallopian tube, or peritoneum, as these are all managed in a similar manner. Most of the recommendations are based on data from patients with the most common subtypes─high-grade serous and grade 2/3 endometrioid. The NCCN Guidelines also include recommendations specifically for patients with less common ovarian cancers, which in the guidelines include the following: carcinosarcoma, clear cell carcinoma, mucinous carcinoma, low-grade serous, grade 1 endometrioid, borderline epithelial, malignant sex cord-stromal, and malignant germ cell tumors. This manuscript focuses on certain aspects of primary treatment, including primary surgery, adjuvant therapy, and maintenance therapy options (including PARP inhibitors) after completion of first-line chemotherapy.

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“…The standard therapy for ovarian cancer is the combination of maximal surgical effort and platinum-based chemotherapy [8,9]. Surgical outcome [10] has been proven to be a main predictive factor for the patients' outcome, with the highest benefit obtained at total macroscopic tumor clearance [11].…”

Section: Introductionmentioning

confidence: 99%

Predictive biomarker for surgical outcome in patients with advanced primary high-grade serous ovarian cancer. Are we there yet? An analysis of the prospective biobank for ovarian cancer

Keunecke

Kulbe

Dreher

et al. 2022

Gynecologic Oncology

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Clinical Outcome After Completion Surgery in Patients With Ovarian Cancer: The Charite Experience

Cited by 9 publications

References 30 publications

The role of computed tomography in predicting peritoneal carcinomatosis and upfront surgery outcome in advanced ovarian cancer

The role of computed tomography in predicting peritoneal carcinomatosis and upfront surgery outcome in advanced ovarian cancer

Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology

Predictive biomarker for surgical outcome in patients with advanced primary high-grade serous ovarian cancer. Are we there yet? An analysis of the prospective biobank for ovarian cancer

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