scholarly journals EPV217/#534 Impact of residual tumor size by computed tomography after primary optimal cytoreduction on prognosis of advanced ovarian cancer

2021 ◽  
Author(s):  
H Lim ◽  
SJ Park ◽  
EJ Lee ◽  
M Lee ◽  
SY Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Tumor Size ◽  
Advanced Ovarian Cancer ◽  
Residual Tumor ◽  
Optimal Cytoreduction ◽  
Residual Tumor Size

Prognostic Value of Residual Tumor Size in Patients With Epithelial Ovarian Cancer FIGO Stages IIA–IV: Analysis of the OVCAD Data

2012 ◽  
Vol 22 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Stephan Polterauer ◽  
Ignace Vergote ◽  
Nicole Concin ◽  
Ioana Braicu ◽  
Radoslav Chekerov ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Tumor Size ◽  
Residual Disease ◽  
Tumor Resection ◽  
Residual Tumor ◽  
Residual Tumor Size ◽  
Complete Tumor

ObjectiveThe objective of the study was to evaluate the prognostic impact of residual tumor size after cytoreductive surgery in patients with epithelial ovarian cancer.MethodsIn this prospective, multicenter study, 226 patients with epithelial ovarian cancer (International Federation of Gynecology and Obstetrics stages IIA–IV) were included. Patients were treated with cytoreductive surgery and adjuvant platinum-based chemotherapy. Univariate and multivariable survival analyses were performed to investigate the impact of residual tumor size on progression-free and overall survival.ResultsIn 69.4% of patients, surgery resulted in complete tumor resection; minimal residual disease (≤1 cm) was achieved in 87.2% of patients. Advanced tumor stage was associated with a lower rate of complete tumor resection (P < 0.001). After cytoreductive surgery, 3-year overall survival rates were 72.4%, 65.8%, and 45.2% for patients without, with minimal, and with gross residual disease (>1 cm), respectively (P < 0.001). Multivariable survival analysis revealed residual tumor size (P = 0.04) and older patient age (P = 0.02) as independent prognosticators for impaired overall survival. Complete cytoreduction was predictive for a higher rate of treatment response (P = 0.001) and was associated with prolonged progression-free and overall survival (P < 0.001 and P = 0.001).ConclusionsThe size of residual disease after cytoreduction is one of the most crucial prognostic factors for patients with ovarian cancer. Patients after complete cytoreduction have a superior outcome compared with patients with residual disease. Leaving no residual tumor has to be the aim of primary surgery for ovarian cancer; therefore, patients should receive treatment at centers able to undertake complex cytoreductive procedures.

scholarly journals The Significance of Preoperative Computed Tomography for Predicting Optimal Cytoreduction in Advanced Ovarian Cancer

2020 ◽  
Vol 80 (09) ◽  
pp. 915-923
Author(s):  
Angrit Stachs ◽  
Karen Engel ◽  
Johannes Stubert ◽  
Toralf Reimer ◽  
Bernd Gerber ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Advanced Ovarian Cancer ◽  
Figo Stage ◽  
Tumour Resection ◽  
Residual Tumour ◽  
Optimal Cytoreduction

Abstract Introduction Optimal cytoreduction is the most important prognostic factor in advanced ovarian cancer. Although staging and assessment of operability are made by exploratory surgery, preoperative computed tomography (CT) of the abdomen is regarded as standard. The aim of this study was to examine various CT parameters with regard to prediction of optimal cytoreduction. Patients and Methods The retrospective study included 131 patients with ovarian cancer newly diagnosed between 2010 and 2014. Of these, n = 36 with FIGO stage I to IIB were excluded from the study. A preoperative abdominal CT was available for n = 75 of the 95 patients with FIGO stage IIC to IV. The CT scans underwent blinded review. The 11 evaluated CT parameters were examined by means of χ2 test and logistic regression analysis with regard to the endpoints of macroscopic residual tumour and residual tumour > 1 cm. Survival analyses used the Kaplan-Meier method and log rank test. Results Of 75 patients, 28 (37.3%) had complete tumour resection and 26 (34.7%) had residual tumour ≤ 1 cm. Residual tumours > 1 cm were found in 21 (28%) patients, five of which were not resectable. Overall survival with residual tumour > 1 cm differed significantly from the group with no macroscopic residual tumour (p = 0.003) and with residual tumour ≤ 1 cm (p = 0.04). The CT parameters tumour foci in the diaphragm, mesocolon, greater omentum and peritoneum as well as ascites correlated with macroscopic residual tumour. In the multivariate logistic regression analysis only the CT parameter intraparenchymal liver metastasis was statistically significant with regard to prediction of suboptimal tumour resection (> 1 cm) (OR 8.04; 95% CI 1.57 – 42.4; p = 0.0134). The sensitivity, specificity, PPV and NPV were 37.5, 89.7, 66.7 and 72.2%. Conclusion Although risk parameters for suboptimal tumour reduction can be identified by CT of the abdomen, surgical exploration with histological confirmation of the diagnosis is essential because of the poor diagnostic accuracy.

Is Postoperative Computed Tomography Evaluation a Prognostic Indicator in Patients with Optimally Debulked Advanced Ovarian Cancer?

Oncology ◽  
2014 ◽  
Vol 87 (5) ◽  
pp. 293-299 ◽  
Author(s):  
Domenica Lorusso ◽  
Italo Sarno ◽  
Violante Di Donato ◽  
Antonella Palazzo ◽  
Elena Torrisi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Prognostic Indicator

The rate and role of diaphragmatic peritonectomy in optimal cytoreduction in patients with advanced stage ovarian cancer: a prospective study of 100 patients

2014 ◽  
Vol 21 (1) ◽  
pp. 1-7
Author(s):  
Tomas Lūža ◽  
Agnė Ožalinskaitė ◽  
Vilius Rudaitis
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Cytoreductive Surgery ◽  
Residual Disease ◽  
Advanced Ovarian Cancer ◽  
Optimal Cytoreduction ◽  
Entire Cohort ◽  
Kaplan Meier ◽  
Upper Abdominal ◽  
A Prospective Study

Background. Diaphragmatic peritoneal metastasis by advanced epi­thelial ovarian cancer is a very common holdback precluding optimal cytoreduction. The aim of this study was to determine the rate of dia­phragmatic peritonectomy during optimal cytoreductive surgery and its role in postoperative morbidity and survival in patients with advanced ovarian cancer. Materials and methods. 100 consecutive patients with advanced epithelial ovarian cancer underwent cytoreductive surgery and were followed up prospectively (January 2009 – March 2014). Characteristics of surgery, rate of diaphragmatic peritonectomy and post operative complications were assessed. The Kaplan-Meier method was used for survival analysis. Results. The median age of the entire cohort at the time of primary cytoreduction was 58.5 years (23–83). Optimal cytoreduction was achieved in 73 cases out of 100 patients. From 73 patients in 30 cases (41.1%) upper abdominal procedures, specifically diaphragmatic peritonectomy, was performed to achieve the main goal of cytoreduction  –  no visible or palbable disease at the end of cytoreduction. Non-optimal cytoreduction was achieved in 27 cases. According to the Clavien-Dindo complication grading system grade I and grade II complications occurred more often in patients that underwent diaphragmatic surgery. The median overall survival from the time of diagnosis to the last follow-up or death was 28 months (range 0–63 months). The factors associated with the longest survival after primary cytoreductive surgery were the disease free interval from the primary cytoreduction of more than 19 months (n = 51) versus less than 19 months (n = 49) (95% confidence interval, 51.7–59.5; P = 0.013) and no visible or palpable residual disease at the end of cytoreduction (n = 73) versus visible or palpable residual di­sease (n = 27) (95% confidence interval, 52.7–61.2; P = 0.03). Conclusions. Based on our prospective analysis of advanced ovarian cancer patients, diaphragmatic peritonectomy is feasible and safe, ensures better rates of optimal cytoreduction and should not be an obstacle towards better survival.

Sign in / Sign up

Export Citation Format

Share Document