Debulking surgery for incompletely operated advanced epithelial ovarian carcinoma

Gültekin, Murat; Dursun, Polat; Doğan, Nasuh Utku; Kolusarı, Ali; Yüce, K.; Ayhan, Ali

doi:10.1002/jso.21274

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Ovarian cancer (OC) is the most fatal of all gynaecologic malignancies in women. Optimal cytoreductive surgery is the most significant prognostic factor in the management of OC (Harlan et al, 2003;Gultekin et al, 2009). In the event of high index of suspicion for ovarian cancer, patients should undergo surgery in tertiary care units where optimal cytoreductive surgery could be performed.…”

Section: Introductionmentioning

confidence: 99%

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

Yavuzcan¹,

Çağlar²,

Özgü³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

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Section: Introductionmentioning

confidence: 99%

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

Yavuzcan¹,

Çağlar²,

Özgü³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Higher complication rate was reported in women who underwent interval cytoreduction compared to upfront completion surgery (26.9 vs. 9.1 %), and the study recommended upfront resurgery over interval cytoreduction when feasible. Gultekin et al reported significantly higher median survival in those patients who underwent upfront completion surgery over those who underwent primary debulking surgery for unexplained reasons (39 vs. 25 months, P = 0.03) [14]. Residual disease was the most important prognostic factor.…”

Section: Discussionmentioning

confidence: 93%

The Role of Completion Surgery in Ovarian Cancer

Thomas

Sebastian

et al. 2015

J Obstet Gynecol India

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“…6 More recently, for ovarian carcinomatosis, the definition of optimal cytoreductive surgery has evolved, and most authors consider that ''optimal'' should signify macroscopically complete removal of disease, not residual tumor nodules of less than 1-2 cm. 7,8 In conclusion, for carcinomatosis from appendiceal cancer and various origins, the adequate and early therapeutic management combining complete cytoreductive surgery and intraperitoneal chemotherapy will achieve better oncologic outcomes. The negative impact of inadequate previous debulking surgery should be underlined and disseminated to general surgeons and oncologists.…”

mentioning

confidence: 99%

Peritoneal Carcinomatosis from Appendiceal Cancer: Early Adequate Therapeutic Management for Long-Term Survival

2011

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Debulking surgery for incompletely operated advanced epithelial ovarian carcinoma

Abstract: A history of an incomplete primary surgery does not seem to adversely affect patient prognosis and the optimal cytoreductive success achieved in final debulking surgery is still the most important prognostic factor.

Cited by 4 publications

References 13 publications

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

The Role of Completion Surgery in Ovarian Cancer

Peritoneal Carcinomatosis from Appendiceal Cancer: Early Adequate Therapeutic Management for Long-Term Survival

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