Martina Aida Angeles1, Gwénaël Ferron2, Bastien Cabarrou3, Gisèle Balague4, Carlos Martínez-Gómez5, Laurence Gladieff6, Christophe Pomel7, Alejandra Martinez8. 1. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 2. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 19, Toulouse, France. 3. Biostatistics Unit, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 4. Department of Radiology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 5. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 1, Toulouse, France. 6. Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France. 7. Department of Surgical Oncology, CRLCC Jean Perrin, Clermont-Ferrand, France. 8. Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France; INSERM CRCT 1, Toulouse, France. Electronic address: Martinez.Alejandra@iuct-oncopole.fr.
Abstract
INTRODUCTION: Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate complete cytoreduction and the feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in these patients has been demonstrated. The aim of our study was to assess the prognostic impact of CLN involvement in patients with primary advanced OC undergoing a complete cytoreductive surgery (CRS). MATERIAL AND METHODS: We designed a retrospective unicentric study. We reviewed data from patients who underwent CLN resection with or without porta hepatis disease resection, within upfront or interval complete CRS in the frontline treatment of advanced epithelial OC between January 2008 and December 2015. Patients were classified in two groups according to CLN status. Univariate and multivariate analyses were conducted. Survival rates were estimated using Kaplan-Meier method. RESULTS: Forty-three patients were included and positive CLN were found in 39.5% of them. The median disease-free survival in the group of patients with positive and negative CLN were 11.3 months and 25.8 months, respectively. In multivariable analysis, both CLN involvement and high peritoneal cancer index were independently associated with decreased disease-free survival. Computed tomography re-reading by an expert radiologist has good sensitivity for detection of positive CLN. CONCLUSION: CLN involvement and high preoperative tumor burden are independently associated with decreased survival after complete cytoreduction for OC. CLN involvement is a marker of diffuse disease and an independent risk factor for early recurrent disease.
INTRODUCTION: Completeness of cytoreduction is the most important prognostic factor in patients with advanced ovarian cancer (OC). Extensive upper abdominal surgery has allowed to increase the rate complete cytoreduction and the feasibility of resection of celiac lymph nodes (CLN) and porta hepatis disease in these patients has been demonstrated. The aim of our study was to assess the prognostic impact of CLN involvement in patients with primary advanced OC undergoing a complete cytoreductive surgery (CRS). MATERIAL AND METHODS: We designed a retrospective unicentric study. We reviewed data from patients who underwent CLN resection with or without porta hepatis disease resection, within upfront or interval complete CRS in the frontline treatment of advanced epithelial OC between January 2008 and December 2015. Patients were classified in two groups according to CLN status. Univariate and multivariate analyses were conducted. Survival rates were estimated using Kaplan-Meier method. RESULTS: Forty-three patients were included and positive CLN were found in 39.5% of them. The median disease-free survival in the group of patients with positive and negative CLN were 11.3 months and 25.8 months, respectively. In multivariable analysis, both CLN involvement and high peritoneal cancer index were independently associated with decreased disease-free survival. Computed tomography re-reading by an expert radiologist has good sensitivity for detection of positive CLN. CONCLUSION:CLN involvement and high preoperative tumor burden are independently associated with decreased survival after complete cytoreduction for OC. CLN involvement is a marker of diffuse disease and an independent risk factor for early recurrent disease.
Authors: Orestis Tsonis; Fani Gkrozou; Konstantinos Vlachos; Minas Paschopoulos; Michail C Mitsis; Nikolaos Zakynthinakis-Kyriakou; Stergios Boussios; George Pappas-Gogos Journal: Ann Transl Med Date: 2020-12
Authors: Violante Di Donato; Andrea Giannini; Ottavia D'Oria; Michele Carlo Schiavi; Anna Di Pinto; Margherita Fischetti; Francesca Lecce; Giorgia Perniola; Francesco Battaglia; Pasquale Berloco; Ludovico Muzii; Pierluigi Benedetti Panici Journal: Ann Surg Oncol Date: 2020-08-10 Impact factor: 5.344