Surgical staging of early invasive epithelial ovarian tumors

Leblanc, Éric; Querleu, Denis; Narducci, Fabrice; Chauvet, Marie‐Pierre; Chevalier, A.; Lesoin, A.; Vennin, Philippe; Taïeb, S.

doi:10.1002/1098-2388(200007/08)19:1<36::aid-ssu6>3.3.co;2-5

Cited by 6 publications

(17 citation statements)

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“…Statistically, these occult lesions are found in the diaphragm (7%), the omentum (5%), peritoneal biopsy specimens (10%), and peritoneal cytology (20%) (Leblanc et al, 2000).…”

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confidence: 99%

Photodynamic diagnosis of ovarian cancer using hexaminolaevulinate: a preclinical study

et al. 2003

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The unfailing detection of micrometastases during surgery of patients suffering from ovarian cancer is mandatory for the optimal management of this disease. Thus, the present study aimed at determining the feasibility of detecting micrometastases in an ovarian cancer model using the intraperitoneal administration of the photosensitiser precursor hexaminolaevulinate (HAL). For this purpose, HAL was applied intraperitoneally at different concentrations (4 -12 mM) to immunocompetent Fischer 344 rats bearing a syngeneic epithelial ovarian carcinoma. The tumours were visualised laparoscopically using both white and blue light (D-light, Karl Storz, Tuttlingen, Germany), and the number of peritoneal micrometastases detected through HAL-induced photodiagnosis (PD) was compared to standard white light visualisation. Fluorescence spectra were recorded with an optical fibre-based spectrofluorometer and the fluorescence intensities were compared to the protoporphyrin IX (PpIX) fluorescence induced by 5-aminolevulinic acid under similar conditions. The number of metastases detected by the PD blue light mode was higher than when using standard white light abdominal inspection for all applied concentrations. Twice as many cancer lesions were detected by fluorescence than by white light inspection. The hexyl-ester derivative produced higher PpIX fluorescence than its parent substance aminolevulinic acid at the same concentration and application time. Fluorescence contrast between healthy and cancerous tissue was excellent for both compounds. To overcome poor diagnostic efficiency and to detect peritoneal ovarian carcinoma foci in the large surface area of the human peritoneal cavity, HAL fluorescence-based visualisation techniques may acquire importance in future and lead to a more correct staging of early ovarian cancer.

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“…Statistically, these occult lesions are found in the diaphragm (7%), the omentum (5%), peritoneal biopsy specimens (10%), and peritoneal cytology (20%) (Leblanc et al, 2000).…”

mentioning

confidence: 99%

Photodynamic diagnosis of ovarian cancer using hexaminolaevulinate: a preclinical study

et al. 2003

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“…Ovarian cancer has a well-established widespread peritoneal dissemination. [2][3][4] Although the surface of the appendix constitutes less than 1% of the peritoneal cavity, it is suggested as a frequent metastatic site. In our study, the overall incidence of metastasis to appendix in ovarian cancer was 50.98%.…”

Section: Discussionmentioning

confidence: 99%

Routine appendicectomy be performed as a part of surgical staging in ovarian cancer

Giri

Lal

Rawal

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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“…The stage must be confirmed by surgery, using a set of wellstandardized procedures (2,10) . These staging procedures have been found feasible by laparoscopy, and studies have described the laparoscopic management of patients with early-stage cancer of the adnexa.…”

Section: Discussionmentioning

confidence: 99%

“…Experience acquired over the past 15 years has shown that laparoscopy performs as well as laparotomy for evalu-ating or treating gynecological or colonic cancers. A few studies of laparoscopy for initial staging or restaging of stage I ovarian cancer have produced promising results (2)(3)(4)(5)(6)(7)(8) . In theory, all the procedures needed for treating and staging stage I ovarian cancer can be done laparoscopically.…”

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confidence: 99%

Impact of initial surgical access on staging and survival of patients with stage I ovarian cancer

Lécuru,

Desfeux,

Camatte

et al. 2006

Int J Gynecol Cancer

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The aim of this study was to compare staging by laparoscopy and laparotomy, and to compare survival in patients with laparoscopy versus laparotomy as the first surgical access. We conducted a retrospective analysis of patients with stage I ovarian cancer treated surgically between 1985 and 2001, and we included those patients with stage I epithelial cancer for whom follow-up data were available. For each patient, we recorded whether initial surgical staging was by laparoscopy or by laparotomy, the procedures done at initial staging surgery, and the outcomes. The data were evaluated by analysis of variance, Chi-square test or Fisher's exact test, logistic regression, Cox model, and log-rank test, using SPSS 7.5 and STATA. Initial staging was by laparoscopy in 34 patients, laparotomy in 114 patients, and laparoscopy converted to laparotomy in 30 patients. In the laparotomy group, patient age was significantly greater and tumor size significantly larger, as compared to the laparoscopy group. Staging after first surgery was often inadequate; most notably para-aortic lymph node dissection was done in 0% of laparoscopy patients, 18% of laparotomy patients, and 33% of conversion patients. Restaging surgery has been indicated in 88% of laparoscopy patients, 48% of laparotomy patients, and 46% of conversion ones. After a mean follow-up of 40 months, survival rates were not significantly different among the three patient groups. No deleterious influence of laparoscopy as first surgical access was detected by univariate or multivariate analysis. Despite of inaccurate radicality and staging during initial laparoscopy, this study found no harmful influence of laparoscopy as first initial access on outcomes of patients with stage I ovarian cancer.

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Surgical staging of early invasive epithelial ovarian tumors

Cited by 6 publications

References 0 publications

Photodynamic diagnosis of ovarian cancer using hexaminolaevulinate: a preclinical study

Photodynamic diagnosis of ovarian cancer using hexaminolaevulinate: a preclinical study

Routine appendicectomy be performed as a part of surgical staging in ovarian cancer

Impact of initial surgical access on staging and survival of patients with stage I ovarian cancer

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