Preoperative Predictors of Optimal Tumor Resectability in Patients With Epithelial Ovarian Cancer

Abstract

BackgroundSeveral studies have shown that whether complete tumor resection can be achieved during debulking surgery depends on various patient-related factors. However, none of these studies was conducted among patients with epithelial ovarian cancer (EOC) in sub-Saharan Africa. In this study, we aimed to determine the preoperative predictors of optimal tumor resectability (OTR) during primary debulking surgery (PDS) in patients with EOC. MethodologyIn this study, we reviewed all patients with histologically diagnosed EOC who underwent PDS between January 2011 and December 2020. We included 83 patients with complete clinical records for subsequent data analysis. Descriptive statistics were computed for patients' data, and binary logistic regression analysis was used to assess the strength of associations between patients' preoperative characteristics and OTR. ResultsThe overall rate of OTR was 53.0%, while the rate in advanced EOC patients was 36.1%. In the univariate analyses, pleural effusion, ascites, tumor bilaterality, size of the largest tumor, retroperitoneal lymph nodes, omental caking, peritoneal thickening, significant extrapelvic tumor, serum cancer antigen-125 (CA-125) levels, and hemoglobin levels were recorded as the predictors of OTR. However, after adjusting for covariates in the final multivariate models, we found that the absence of moderate-to-large pleural effusion (odds ratio (OR) = 5.60; 95% confidence interval (CI) = 1.32, 23.71) and having serum CA-125 levels of ≤370

Significance of Pretreatment Hemoglobin-Albumin-Lymphocyte-Platelet Index for the Prediction of Suboptimal Surgery in Epithelial Ovarian Cancer

“…Achieving optimal cytoreductive surgery in high-volume medical centers typically earns complete gross resection rates ranging from 50% to 70% in patients with AEOC [ 31 , 32 ]. Nonetheless, patients with AEOC with a high tumor burden and limited physical capabilities often face difficulties achieving complete tumor resection during the primary surgical procedure.…”

Survival outcomes following interval versus primary debulking surgery in advanced epithelial ovarian cancer: A retrospective cohort study in Lagos, Southwest Nigeria

“… 9 Optimal surgical debulking is not always possible for advanced-stage diseases, especially in women with very extensive diseases beyond the pelvis 9 or those with a major medical condition that may impair their performance status and inability to withstand an extensive PDS. 10 In such instances, surgery can be intricate, occasionally necessitating substantial bowel resection and significant blood loss, posing a considerable risk of morbidity and mortality. 9 , 11 , 12 When PDS is not feasible, secondary surgery referred to as interval debulking surgery (IDS) may be carried out after an initial tumour response in between a few courses of chemotherapy.…”