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RESEARCH PRODUCT

Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience

Francesco FanfaniBarbara CostantiniMarco PetrilloAlfredo ErcoliGiovanni ScambiaLucia TortorellaVito ChianteraAnna FagottiRaffaella IodiceGiuseppe Vizzielli

subject

AdultOncologymedicine.medical_specialtyNeoplasm ResidualAdult; Aged; Aged; 80 and over; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Laparoscopy; Middle Aged; Neoplasm Staging; Neoplasm; Residual; Ovarian Neoplasms; Peritoneal Neoplasms; Prognosis; Retrospective Studies; Survival Rate; Tumor BurdenPopulationlaparoscopySurgical oncologyInternal medicineHumansMedicineeducationLaparoscopySurvival ratePeritoneal NeoplasmsAgedNeoplasm StagingRetrospective StudiesAged 80 and overOvarian Neoplasmseducation.field_of_studymedicine.diagnostic_testPerformance statusbusiness.industryMedicine (all)Retrospective cohort studyMiddle AgedPrognosismedicine.diseaseDebulkingCombined Modality TherapyTumor BurdenSurvival Rateovarian cancerSettore MED/40 - GINECOLOGIA E OSTETRICIAOncologyFemaleSurgerybusinessOvarian cancerFollow-Up Studies

description

Purpose: The aim of this study was to investigate whether preoperative laparoscopic evaluation of the dissemination of disease may have an independent impact on survival in advanced epithelial ovarian cancer (AEOC).Methods: All AEOC women were submitted to staging laparoscopy before receiving primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT). All study women received a laparoscopic score (predictive index value [PIV]) and were stratified into three groups based on volume of disease: high tumor load (HTL) for PIV ≥8, intermediate tumor load (ITL) for PIV equal to 6 and 4, and low tumor load (LTL) for PIV 1 cm in 15 cases (9.1 %). When stratifying the whole population according to laparoscopic tumor load, the median progression-free survival (PFS) was 33 months for LTL, 18 months for ITL, and 14 months for HTL (p = 0.0001). The median overall survival (OS) with respect to laparoscopic PIV was not reached for LTL, whereas it was 47 months for ITL and 33 months for HTL, respectively (p = 0.0001). At multivariate analysis, tumor load stratified by PIV retained an independent prognostic value on PFS and OS, together with RT and performance status.Conclusions: RT remains an important prognostic factor in patients with AEOC, but tumor dissemination can play a role in determining prognosis in these women.

yearjournalcountryeditionlanguage
2014-01-01Annals of Surgical Oncology
https://doi.org/10.1245/s10434-014-3783-6