Splenectomy and surgical cytoreduction in epithelial ovarian cancer: a review

Hanprasertpong, Jitti

doi:10.1111/j.1365-2354.2010.01224.x

Cited by 9 publications

(11 citation statements)

References 44 publications

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“…The authors of these studies did not include PSM as a variable in their survival analyses; therefore, it is unclear whether they would have come to a similar conclusion as demonstrated in our study. Since splenectomy can be performed with acceptable morbidity [13,[15][16][17], our results support the continued inclusion of splenectomy as part of the standard procedures utilized during cytoreductive surgery for advanced ovarian cancer [18].…”

Section: Discussionsupporting

confidence: 66%

Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer

Tanner¹,

Long²,

Feffer³

et al. 2013

Gynecologic Oncology

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Section: Discussionsupporting

confidence: 66%

Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer

Tanner¹,

Long²,

Feffer³

et al. 2013

Gynecologic Oncology

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“…19 , 20 Metastatic splenic lesions are always more than 1 cm and it is difficult to achieve optimal cytoreductive surgery for those patients without splenectomy, which may influence prognosis. 21 …”

Section: Discussionmentioning

confidence: 99%

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Sun

Cao

et al. 2018

CMAR

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BackgroundThe aim of the study was to analyze the underlying causes and application of splenectomy in patients with epithelial ovarian cancer (EOC) and assess its effect on the surgical satisfaction and prognosis of these patients.Materials and methodsClinical data of patients with ovarian epithelial cancer treated with cytoreductive surgery were collected from 2000 to 2015 at Peking Union Medical College Hospital.ResultsA total of 2,882 patients underwent ovarian cancer cytoreductive surgery at Peking Union Medical College Hospital between 2000 and 2015, of whom 38 (1.3%) also underwent spleen resections. Of these 38 patients, one underwent splenectomy due to intraoperative trauma, whereas the remaining 37 patients underwent splenectomy due to splenic metastasis. Among these 37 patients, 27 underwent resection due to direct tumor spread in the spleen and 10 underwent resection due to hematogenous metastasis. For subsequent first-line chemotherapy, 22 patients were platinum sensitive and 15 were platinum resistant. Overall median survival and the postsplenectomy median survival time were 106 and 75 months, respectively. The overall median survival in secondary cytoreduction was 101 months compared with 20.3–56 months in literature reviews. Univariate analysis revealed that platinum resistance to first-line chemotherapy, suboptimal surgery, and hematogenous metastasis influenced survival. Chemosensitivity and residual disease were identified as independent risk factors by multivariate analysis. We also report a literature review concerning the efficacy and safety of splenectomy during cytoreductive surgery in EOC.ConclusionApproximately 1.3% of patients with EOC underwent spleen resection during initial cytoreductive surgery and more often during recytoreductive surgery. Tumor involvement was the most common indication for splenectomy, and rare patients underwent splenectomy due to intraoperative trauma. Most patients achieved optimal surgery, and thus their overall survival and postsplenectomy survival rates were longer. The prognosis of patients was closely related to chemosensitivity and presence of residual tumors. Splenectomy should be attempted in all patients with splenic involvement in whom optimal cytoreductive surgery was achievable, no matter in primary or secondary cytoreduction.

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“…Because of this unique and furtive mode of dissemination, efforts in developing methods for early detection of EOC have been largely unsuccessful [4], [5], [6]. Despite cytoreductive surgery, combination chemotherapies and strategies for determining serum biomarkers, local and disseminated chemoresistant cells persist and eventually flourish, leading to the high recurrence and <25% five-year survival rate of patients with EOC [3], [5], [7], [8], [9]. Thus, a better understanding of the cellular and molecular mechanisms governing EOC dissemination and invasion has the potential to have significant impact on the course of the disease.…”

Section: Introductionmentioning

confidence: 99%

Protein Kinase A Activity and Anchoring Are Required for Ovarian Cancer Cell Migration and Invasion

2011

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Epithelial ovarian cancer (EOC) is the deadliest of the gynecological malignancies, due in part to its clinically occult metastasis. Therefore, understanding the mechanisms governing EOC dissemination and invasion may provide new targets for antimetastatic therapies or new methods for detection of metastatic disease. The cAMP-dependent protein kinase (PKA) is often dysregulated in EOC. Furthermore, PKA activity and subcellular localization by A-kinase anchoring proteins (AKAPs) are important regulators of cytoskeletal dynamics and cell migration. Thus, we sought to study the role of PKA and AKAP function in both EOC cell migration and invasion. Using the plasma membrane-directed PKA biosensor, pmAKAR3, and an improved migration/invasion assay, we show that PKA is activated at the leading edge of migrating SKOV-3 EOC cells, and that inhibition of PKA activity blocks SKOV-3 cell migration. Furthermore, we show that while the PKA activity within the leading edge of these cells is mediated by anchoring of type-II regulatory PKA subunits (RII), inhibition of anchoring of either RI or RII PKA subunits blocks cell migration. Importantly, we also show – for the first time – that PKA activity is up-regulated at the leading edge of SKOV-3 cells during invasion of a three-dimensional extracellular matrix and, as seen for migration, inhibition of either PKA activity or AKAP-mediated PKA anchoring blocks matrix invasion. These data are the first to demonstrate that the invasion of extracellular matrix by cancer cells elicits activation of PKA within the invasive leading edge and that both PKA activity and anchoring are required for matrix invasion. These observations suggest a role for PKA and AKAP activity in EOC metastasis.

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Splenectomy and surgical cytoreduction in epithelial ovarian cancer: a review

Cited by 9 publications

References 44 publications

Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer

Parenchymal splenic metastasis is an independent negative predictor of overall survival in advanced ovarian, fallopian tube, and primary peritoneal cancer

Splenectomy during cytoreductive surgery in epithelial ovarian cancer

Protein Kinase A Activity and Anchoring Are Required for Ovarian Cancer Cell Migration and Invasion

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