Rectosigmoid resection during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer: morbidity of gynecologic oncology vs. colorectal team

Tozzi, Roberto; Vinti, Daniele; Campanile, Riccardo Garruto; Cristaldi, M.; Ferrari, Federico

doi:10.3802/jgo.2021.32.e42

Cited by 10 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This nding is con rmed by other studies comparing operations performed by gynecologists oncologists and intestinal surgeons. However, the data are only for primary cytoreduction [23,24] In our study, the mean PFS for all patients was 13,4 months, but for the subpopulation with complete secondary cytoreduction surgery (R0), it was 15,5 months. Despite a high percentage of complete cytoreduction 87,5, the PFS in our study was shorter than that in the DESKTOP I-III study (18,4 months), the CALIPSO study (18,2 months), the GOG 213 study (18,9 months) and the SOC-1 study (17,4 months).…”

Section: Discussionmentioning

confidence: 51%

Tumor-bowel fistula as a rare form of recurrent ovarian cancer – imaging and treatment. The pilot study

Jankowska-Lombarska

Grabowska-Derlatka

Derlatka

2022

Preprint

View full text Add to dashboard Cite

Background. The aim of this pilot study was to evaluate the value of imaging techniques (CT and MRI) in the diagnosis of a tumor-bowel fistula as a rare form of epithelial ovarian cancer (EOC) relapse. We also performed an initial assessment of the effectiveness of the treatment of this form of relapse. Methods. The study group consisted of 8 patients with suspected platinum-sensitive recurrence in the form of a tumor/bowel fistula. All patients finished their first line of chemotherapy and subsequently showed complete remission for 6 months or more. To qualify patients for further treatment, CT and MRI were performed, which suggested the presence of a fistula between the recurrent tumor and intestine. DESKTOP study criteria were used to qualify patients for secondary cytoreduction. Second-line chemotherapy was given after secondary debulking. Results. In all patients, fistulas formed between the tumor and large bowel. On CT, the fistulas were indirectly visible. In all cases, the fistula was visible on MR images, which showed hypointensity on the T2 and T1 postcontrast sequences but did not show restricted diffusion on the diffusion-weighted imaging (DWI) sequence. Patients who were qualified for the study underwent secondary debulking with bowel resection. In all eight cases, the fistula between the tumor and surrounding organs was confirmed. During surgery, seven intestinal anastomoses and one colostomy were performed. No residual macroscopic tumor remained in seven cases (resection R0-87,5%). The progression-free survival was 8.4-22.6 months (median 13.4). In the group with cytoreduction R0, the median PFS was 15.5 months (12-22). Conclusion. In the case of relapsed EOC in patients with clinical symptoms in the form of a fistula, CT should not be the only diagnostic method, as MRI is a superior method for diagnosing fistulas. Bowel resection with simultaneous anastomosis seems to be a good and safe solution for these patients. However, an appropriate qualification for surgery is essential.

show abstract

Section: Discussionmentioning

confidence: 51%

Tumor-bowel fistula as a rare form of recurrent ovarian cancer – imaging and treatment. The pilot study

Jankowska-Lombarska

Grabowska-Derlatka

Derlatka

2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In a retrospective cohort study, examined the association between residual disease and prognosis by histological type of ovarian cancer using data from the National Cancer Database of America, OS differed significantly according to residual disease status not only in patients with high-grade serous carcinoma but also in those with clear cell carcinoma and, while not statistically significantly different, the survival benefit associated with complete cytoreduction was greater in clear cell carcinoma (HR 0.39, 95% CI 0.22 to 0.69) than in high-grade serous carcinoma (HR 0.58, 95% CI 0.49 to 0.68) [37]. Different studies have elicited the significance of complete cytoreduction and its impact on survival in ovarian cancer patients [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55].…”

Section: Discussionmentioning

confidence: 98%

The Surgical, Histopathological Characteristics, and Survival Outcome of Ovarian Clear Cell Carcinoma: A Retrospective Case Series Sharing the Experience of a Tertiary Cancer Centre over 10 Years

Tawab¹,

Nistor²,

Roux³

et al. 2023

Preprint

View full text Add to dashboard Cite

A retrospective study including 49 women with ovarian clear cell carcinoma between January 2009 and December 2021 at Oxford cancer centre was done. The mean age was 63 years, with 78% post-menopausal. All women underwent cytoreductive surgery with no residual disease (R0) in 39 women. The follow-up time ranged between 12-144 months, with mean of 105.5 months. The 3-year OS was 73.4%, and 3-year PFS was 81.3%, with a mean of 101.7months (95%CI, 84.63-118.93). As expected, women with stage 1 disease had the best outcome. In comparing OS in respect to absence or presence of residual disease, the 3-year OS was 88.6% (95% CI 108.6-141.8), compared to 12.5% (95% CI 4.48-32.11) respectively (P<0.001). In multivariant analysis the variables included were CA 125 (< or >200 IU/ml), Hb (< or >115 g/L), albumin (< or >40 g/L), associated endometriosis, ascites, residual disease, and FIGO staging. FIGO stage was the only independent prognostic indicator of OS with (p<0.05). Surgery to achieve no residual tumour is necessary to improve the prognosis in advanced OCCC. At present, the true challenge is to predict which patients with early-stage disease are at higher risk of recurrence and would most benefit from adjuvant treatments.

show abstract

“…This finding is confirmed by other studies comparing operations performed by gynecologic oncologists and intestinal surgeons. However, the data are only for primary cytoreduction [23,24].…”

Section: Discussionmentioning

confidence: 99%

Tumor-Bowel Fistula as a Rare Form of Recurrent Ovarian Cancer—Imaging and Treatment: Preliminary Report

2022

View full text Add to dashboard Cite

Background. The aim of this pilot study was to evaluate the value of imaging techniques, including computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of a tumor-bowel fistula as a rare form of epithelial ovarian cancer (EOC) relapse. We also performed an initial assessment of the effectiveness of the treatment of this form of relapse. Methods. The study group consisted of eight patients with suspected platinum-sensitive recurrence in the form of a tumor/bowel fistula. All patients finished their first line of chemotherapy and subsequently showed complete remission for 6 months or more. To qualify patients for further treatment, CT and MRI were performed, which suggested the presence of a fistula between the recurrent tumor and intestine. DESKTOP study criteria were used to qualify patients for secondary cytoreduction. Second-line chemotherapy was given after secondary debulking. Results. In all patients, fistulas formed between the tumor and large bowel. On CT, the fistulas were indirectly visible. In all cases, the fistula was visible on MR images, which showed hypointensity on the T2 and T1 post-contrast sequences but did not show restricted diffusion on the diffusion-weighted imaging (DWI) sequence. Patients who were qualified for the study underwent secondary debulking with bowel resection. In all eight cases, the fistula between the tumor and surrounding organs was confirmed. During surgery, seven intestinal anastomoses and one colostomy were performed. No residual macroscopic tumor remained in seven cases (resection R0-87.5%). The progression-free survival (PFS) was 8.4–22.6 months (median 13.4). In the group with cytoreduction R0, the median PFS was 15.5 months (12–22). Conclusion. In patients with suspected EOC recurrence with clinically suspected fistula, CT scan is not sufficient. In CT, the presence of a fistula is suspected based on indirect symptoms. MRI, as a method with much greater tissue resolution, confirms the diagnosis. In addition, MRI can identify the point of the tumor/bowel junction. This is especially true with a large infiltration covering several intestinal parts. Bowel resection with simultaneous anastomosis is a good and safe solution for these patients. However, appropriate qualification for the procedure is necessary, which will allow for surgery without residual macroscopic disease (R0 surgery). Due to the small number of cases, our results cannot be generalized. We treat them as a hypothesis that can be verified in a larger study.

show abstract

Rectosigmoid resection during Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer: morbidity of gynecologic oncology vs. colorectal team

Cited by 10 publications

References 26 publications

Tumor-bowel fistula as a rare form of recurrent ovarian cancer – imaging and treatment. The pilot study

Tumor-bowel fistula as a rare form of recurrent ovarian cancer – imaging and treatment. The pilot study

The Surgical, Histopathological Characteristics, and Survival Outcome of Ovarian Clear Cell Carcinoma: A Retrospective Case Series Sharing the Experience of a Tertiary Cancer Centre over 10 Years

Tumor-Bowel Fistula as a Rare Form of Recurrent Ovarian Cancer—Imaging and Treatment: Preliminary Report

Contact Info

Product

Resources

About