Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage <scp>T3c</scp> advanced ovarian carcinoma: A retrospective study

Nagasaka, Kazunori; Kawana, Kei; Tomio, Kensuke; Tsuruga, Tetsushi; Mori‐Uchino, Mayuyo; Miura, Shigeki; Miyamoto, Yukio; Ikeda, Yuji; Sone, Kenbun; Adachi, Katsuyuki; Matsumoto, Yōko; Arimoto, Takahide; Oda, Katsutoshi; Osuga, Yutaka; Fujii, Tomoyuki

doi:10.1111/jog.12616

Cited by 9 publications

(7 citation statements)

References 31 publications

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“…This careful examination contributed to increased detection rate of positive‐PWC in this study. Compared to the positive‐PWC rate in patients with R0 status (28%‐39%) reported by previous studies, this study showed a PWC‐positive rate of 59%.…”

Section: Discussioncontrasting

confidence: 79%

“…A few previous studies have reported on the prognostic impact of PWC during IDS in patients with ovarian cancer. Nagasaka et al demonstrated that positive‐PWC at interval surgery, including IDS, predicted significantly shorter PFS (HR 2.36, 95% CI 1.08‐5.29) in the 50 patients with stage IIIc ovarian cancer including the 37 HGSC . However, this study included 33 patients who underwent primary debulking surgery and chemotherapy and only 17 patients who underwent IDS.…”

Section: Discussionmentioning

confidence: 86%

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Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high‐grade serous carcinoma

et al. 2019

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Background and Objectives The aim of this study was to determine whether peritoneal washing cytology (PWC) during interval debulking surgery (IDS) could predict the prognosis of patients with pelvic high‐grade serous carcinoma (HGSC) achieving R0 status. Methods Between January 2007 and May 2018, 110 patients with ovarian/tubal/primary peritoneal HGSC received platinum‐based neo‐adjuvant chemotherapy, followed by IDS at National Cancer Center Hospital, Japan. All the patients achieved R0 debulking status, defined as no macroscopic residual tumor in the peritoneal cavity at the completion of IDS. PWC was performed before debulking during IDS. The survival outcomes were compared between the PWC‐positive and PWC‐negative groups. Results The median progression free survival (PFS) for the entire cohort was 17 months (range, 5‐133 months). The median PFS for the PWC‐positive group was significantly shorter than that of the PWC‐negative group (16 vs 19 months, HR 2.04, 95% CI 1.22‐3.41, P ‐value < 0.01). Increased risk of progression was observed on both univariate and multivariate analyses, including age and FIGO stage (HR 2.28; 95% CI 1.35‐3.84, P < 0.01). Conclusions The positive PWC during IDS was found to predict earlier disease recurrence in patients with pelvic HGSC achieving R0 status. As performing PWC during IDS becomes standard practice, prospective validation should be conducted in the future.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 86%

Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high‐grade serous carcinoma

et al. 2019

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“…Accordingly, peritoneal dissemination is a significant factor in prognosis. Some of these problematic tumors can be eliminated through platinum-based chemotherapy followed by primary debulking surgery; however, sites that have developed chemoresistance will exhibit gradual recurrence shortly thereafter [40]. Although growing numbers of oncoproteins and metastatic genes have been extensively characterized by comprehensive analyses, such as through the TCGA, many of these tumor-promoting proteins do not constitute good drug targets, which represents a major barrier to curing ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

The proteasome deubiquitinase inhibitor bAP15 downregulates TGF-β/Smad signaling and induces apoptosis via UCHL5 inhibition in ovarian cancer

et al. 2019

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The ubiquitin-proteasome pathway plays an important role in the regulation of cellular proteins. As an alternative to the proteasome itself, recent research has focused on methods to modulate the regulation of deubiquitinating enzymes (DUBs) upstream of the proteasome, identifying DUBs as novel therapeutic targets in breast, endometrial, and prostate cancers, along with multiple myeloma. bAP15, an inhibitor of the 19S proteasome DUBs UCHL5 and USP14, results in cell growth inhibition in several human cancers; however, the mechanism remains poorly understood in ovarian cancer. Here, we found that aberrant UCHL5 expression predicted shorter progression-free survival (PFS) in a cohort of 1435 patients with ovarian cancer described in the Gene Expression Omnibus and The Cancer Genome Atlas databases. The subgroup of patients with TP53 mutations was significantly more likely to exhibit poor PFS (p <0.001). Moreover, we found bAP15 could suppress TP53-mutant ovarian cancer cell survival by regulating TGF-β signaling through inhibiting UCHL5 expression and dephosphorylating Smad2, consequently inducing apoptosis. bAP15 (2.5 and 5.0 mg/kg) also exerted significant anti-tumor effect on nude mice bearing subcutaneous SKOV3 xenografts. As activated TGF-β signaling is involved in ovarian cancer progression, these findings suggest that UCHL5 inhibition offers potential opportunities for a novel targeted therapy against TGF-β-activated ovarian cancer.

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“…Interestingly, 13 patients who had undergone complete cytoreduction (39.4%) were PWC-positive. This suggests that residual cancer cells may remain microscopically present in the peritoneum [ 14 ]. Four patients with RD 0<residual tumor size<1 cm were PWC-negative.…”

Section: Discussionmentioning

confidence: 99%

“…The PWC during IDS may overcome the limitations of micrographic evaluation of RD, which can be easily implemented into standard surgical procedures. Although one study by Nagasaka et al [ 14 ] reported that PWC during IDS is associated with progression-free survival (PFS) in patients with advanced ovarian cancer, the efficacy of PWC during IDS and its effects on OS has not yet been determined. Therefore, the aim of this study was to evaluate the efficacy of PWC during IDS in relation to OS.…”

Section: Introductionmentioning

confidence: 99%

Negative peritoneal washing cytology during interval debulking surgery predicts overall survival after neoadjuvant chemotherapy for ovarian cancer

et al. 2018

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ObjectiveOptimal debulking in interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) has been reported as a prognostic factor for patients with ovarian cancer. However, the identification of microscopic residual disease (MRD) using visualization and palpation is subjective. Peritoneal washing cytology (PWC) during IDS is an easy-to-implement, objective approach for assessing disease status, although its clinical relevance and association with MRD is not known. The aim of this study was to evaluate the efficacy of PWC during IDS.MethodsIn total, 164 patients diagnosed with ovarian cancer at our institution were retrospectively evaluated, including 64 who had received NAC. Seventeen patients had undergone an exploratory laparotomy followed by NAC, while the remaining patients were diagnosed based on imaging, peritoneal cytology, and tumor markers. The PWC was performed before intraperitoneal observation at laparotomy during IDS.ResultsNAC-treated patients had stage III–IV disease. IDS was performed in 78.1% of NAC-treated patients. Seventeen patients (26.6%) were PWC-negative and 33 patients (51.6%) were PWC-positive. Fourteen patients (21.9%) had progressive disease and were ineligible for IDS. The median overall survival of the PWC-negative, PWC-positive, and non-IDS groups was 47, 18, and 5 months, respectively. The differences were significant (p<0.01). PWC was an independent prognostic factor in the multivariate Cox regression analysis (p<0.001).ConclusionPWC during IDS may be a prognostic factor for NAC-treated patients with ovarian cancer. PWC may be more useful than visualization and palpation in IDS for determining the presence of MRD.

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Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: A retrospective study

Cited by 9 publications

References 31 publications

Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high‐grade serous carcinoma

Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high‐grade serous carcinoma

The proteasome deubiquitinase inhibitor bAP15 downregulates TGF-β/Smad signaling and induces apoptosis via UCHL5 inhibition in ovarian cancer

Negative peritoneal washing cytology during interval debulking surgery predicts overall survival after neoadjuvant chemotherapy for ovarian cancer

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