Splenectomy as Part of Primary Cytoreductive Surgery for Advanced Ovarian Cancer: A Retrospective Cohort Study

Zapardiel, Ignacio; Peiretti, Michele; Zanagnolo, Vanna; Biffi, Roberto; Bocciolone, Luca; Landoni, Fabio; Aletti, Giovanni; Colombo, Nicoletta; Maggioni, Angelo

doi:10.1097/igc.0b013e3182571479

Cited by 19 publications

(28 citation statements)

References 28 publications

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“…Searching the literature database (PubMed, Embase, Medscape) using the criteria of recurrence, solitary, splenic, ovarian cancer and tubal cancer and the references of retrieved articles, we found 35 cases of splenectomy for recurrent TOC (table 1) [5,6,8,26,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44]. Splenectomy was mainly part of secondary cytoreductive surgery and only in one case of tertiary cytoreduction [43].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors [28,29,30] compared perioperative details and follow-up data between patients who underwent splenectomy and those who did not in the setting of primary cytoreductive surgery for advanced ETOC. No significant differences were observed between groups, leading to the conclusion that this procedure seems to be an acceptable and rational intervention to increase the chances of optimal cytoreduction.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

Sorbi¹,

Prosperi²,

Villanucci³

et al. 2015

Gynecol Obstet Invest

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Isolated parenchymal splenic lesions are very rare and may occur as recurrences in the form of epithelial tubo-ovarian cancer (ETOC). We report a case of solitary parenchymal splenic recurrence of ETOC, which developed 50 months after the initial treatment. A 66-year-old woman underwent laparotomic primary cytoreduction in 2008. After platinum-based chemotherapy, she developed recurrences; thus, she underwent secondary and tertiary cytoreduction in 2011 and 2012 respectively. In April 2013, CT scan documented a solitary parenchymal splenic lesion and it was confirmed by FDG PET/CT. She underwent quaternary cytoreduction by laparoscopic splenectomy. Histopathological evaluation revealed metastatic parenchymal disease consistent with recurrent ETOC. She was alive and disease-free for ten months since splenectomy. In literature there are 35 cases of isolated spleen parenchymal metastasis of ETOC and our report is the first case of laparoscopic splenectomy in the setting of quaternary cytoreduction. Laparoscopic splenectomy as quaternary cytoreduction is safe and feasible and could be congruent to the well-established experiences already reported for the primary, secondary or even tertiary cytoreduction where the absence of residual disease has been translated in a significant survival benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

Sorbi¹,

Prosperi²,

Villanucci³

et al. 2015

Gynecol Obstet Invest

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“…Cytoreduction may include a variety of surgical procedures such as bowel resection, especially rectosigmoid (which is necessary in approximately 30–50% of cases of advanced ovarian cancer), diaphragm stripping, peritoneal resection, splenectomy, partial hepatic or pancreatic resection, cholecystectomy, hysterectomy, and salpingo-oophorectomy [ 4 , 12 – 13 , 16 – 18 ].…”

Section: Primary Cytoreductionmentioning

confidence: 99%

The role of surgery in advanced epithelial ovarian cancer

Martín-Cameán

Delgado-Sánchez

Piñera

et al. 2016

ecancer

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Nowadays, the standard management of advanced epithelial ovarian cancer is correct surgical staging and optimal tumour cytoreduction followed by platinum and taxane-based chemotherapy. Standard surgical staging consists of peritoneal washings, total hysterectomy, and bilateral salpingo-oophorectomy, inspection of all abdominal organs and the peritoneal surface, biopsies of suspicious areas or randomised biopsies if they are not present, omentectomy and para-aortic lymphadenectomy. After this complete surgical staging, the International Federation of Gynaecology and Obstetrics (FIGO) staging system for ovarian cancer is applied to determine the management and prognosis of the patient. Complete tumour cytoreduction has shown an improvement in survival. There are some criteria to predict cytoreduction outcomes based on serum biomarkers levels, preoperative imaging techniques, and laparoscopic-based scores. Optimised patient selection for primary cytoreduction would determine patients who could benefit from an optimal cytoreduction and might benefit from interval surgery. The administration of intraperitoneal chemotherapy after debulking surgery has shown an increase in progression-free survival and overall survival, especially in patients with no residual disease after surgery. It is considered that 3–17% of all epithelial ovarian carcinoma (EOC) occur in young women that have not fulfilled their reproductive desires. In these patients, fertility-sparing surgery is a worthy option in early ovarian cancer.

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“…[12] Splenectomy, for instance, has been evaluated as a safe practice at the time of primary cytoreductive surgery for ovarian cancer, offering better cytoreduction, with low perioperative complication rate. [13] Colon resection, most often rectosigmoidectomy followed by a primary anastomosis, has been found to have a positive impact on survival, [14] improving disease free and overall survival, [15] with an acceptable postoperative quality of life and without a delay on adjuvant systemic chemotherapy. [16] The significance of optimal cytoreduction can be demonstrated also on a microscopic level, since it has been found that intraperitoneal chemotherapy agents under hyperthermic conditions can penetrate tissue to a depth of only 2 to 3 milimeters, [17] therefore HIPEC administration can only be efficient given that meticulous resection has been performed, leaving residual tumor of less than 1 mm -2 mm in thickness.…”

Section: The Role Of Cytoreductive Surgerymentioning

confidence: 99%

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of ovarian cancer

Spiliotis

Halkia

2015

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The most common cause of primary ovarian malignancy is epithelial carcinoma, accounting for 95% of malignant ovarian neoplasia. The lifetime risk of epithelial ovarian cancer (EOC) is 1/70 females, representing the leading cause of gynecologic malignancy death. Due to its indolent clinical course, EOC tends to be diagnosed at an advanced stage, often resulting in unfavorable outcomes, since the stage at diagnosis is the most significant prognostic factor. So far the standard of care for ovarian cancer has been surgery followed by systemic chemotherapy. However, treatment with cytoreductive surgery, as described by Sugarbaker, and hyperthermic intraperitoneal chemotherapy (HIPEC) is another approach, showing promising results.

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Splenectomy as Part of Primary Cytoreductive Surgery for Advanced Ovarian Cancer: A Retrospective Cohort Study

Cited by 19 publications

References 28 publications

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

Laparoscopic Splenectomy as Quaternary Cytoreduction for Isolated Parenchymal Splenic Recurrence of Epitelial Tubo-Ovarian Cancer: Report of a Case and Literature Review

The role of surgery in advanced epithelial ovarian cancer

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of ovarian cancer

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