Liver surgery for advanced ovarian cancer: a systematic review of literature

Abstract

To analyze the surgical treatment of liver metastases from advanced ovarian cancer (AOC) during either primary or interval debulking surgery (PDS or IDS). Data sources, methods of study selection: A systematic research of the literature was conducted in Scopus, PubMed/MEDLINE, ScienceDirect and the Cochrane Library, including observational prospective, retrospective studies, case series and case reports. Tabulation, integration and results: We collected data regarding study features, characteristics of the patients and of liver metastasis, the type of surgical treatment and postoperative morbidity. The type of liver surgery was described according to the terminology of Brisbane 2000 (TB2000). Ten articles were selected, and 61 patients were included, even though data was not complete for all of them. The weighted average age was 57 years old, and most women underwent PDS (n = 21/32 [66%]). The number of liver metastases was available only for 17 patients including 3 (18%) and 14 (82%) with multiple and single lesions, respectively. Metastasis from peritoneal seeding (peritoneal metastasis) was the most common type of lesion (n = 27/42 [64%]). Only in one study the authors declared the specialty of the surgeon performing the procedures (hepatobiliary). Two studies (n = 15) adopted the TB2000 and reported as follow: 47% wedge resections, 33% segmentectomies, 13% hemi-hepatectomies and 7% right-trisegmentectomy. Clavien-Dindo grade III or greater complications was 13% (n = 2/15). Conclusions: Liver resection is feasible during either PDS or IDS. Single lesion and peritoneal metastasis represent the most common conditions. Wedge liver resection is the most frequent procedure. Prognostic advantage is suggested after liver surgery especially for peritoneal metastasis.

Effect of different treatment modalities on ovarian cancer patients with liver metastases: A retrospective cohort study based on SEER

“…Thirdly, due to the limited sample size, it was not possible to conduct subgroup analysis on patients with distant metastases to the liver and brain. Fourthly, as mentioned by Forte S et al, liver resection is feasible during either primary debulking surgery (PDS) or interval debulking surgery (IDS) [ 24 ]. But all the data were obtained from the SEER public database, which prevented us from distinguishing between the sequencing of patients’ chemotherapy and surgery, as well as differentiating between PDS and IDS patients.…”