Jennifer Uzan1, Hélène Bonsang-Kitzis1, Léa Rossi2, Bastien Rance3, Anne-Sophie Bats2, Marie Gosset2, Myriam Deloménie1, Eric Pujade-Lauraine4, Fabrice Lécuru2, Charlotte Ngô5. 1. Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. 2. Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France. 3. Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Department of Medical Informatics, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. 4. Women Cancer Center and Clinical Research, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France. 5. Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France. Electronic address: charlotte.ngo@aphp.fr.
Abstract
INTRODUCTION: Complete removal of disease is the most important prognostic factor for patients with advanced epithelial ovarian carcinoma. However, the influence of carcinomatosis distribution on prognosis is unknown and the prognostic impact of implant size according to their location is poorly studied. Our objective was to assess the impact of peritoneal carcinomatosis quantitative and qualitative localizations on progression free survival (PFS) in patients with advanced epithelial ovarian carcinoma (AEOC) after complete cytoreductive surgery. METHODS: We conducted a monocentric cohort study, retrospective from October 2001 to July 2014. Inclusion criteria were high-grade AEOC patients without residual disease (CC0) after primary debulking surgery (PDS) or after interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Peritoneal carcinomatosis was assessed according to qualitative criteria and quantitative criteria. RESULTS: One hundred and one patients were included. Median PFS was 21·2 months and median OS was 62·2 months. On the whole population, involvement of adipocytes-enriched areas tended to be associated with a decreased PFS and was significantly associated with a decreased OS. Any localization was associated with PFS or OS in the "IDS" subgroup. In the "PDS" subgroup, PCI score and involvement of the right mesocolic area were associated with a decreased PFS. CONCLUSION: Initial tumor load has not been found associated with PFS after complete surgery. Adipocytes-enriched areas and right mesocolic areas involvement were associated with poor prognosis in patients receiving primary debulking surgery. Larger-scale studies are needed to assess whether initial tumor load has a prognostic impact even after complete cytoreductive surgery is achieved.
INTRODUCTION: Complete removal of disease is the most important prognostic factor for patients with advanced epithelial ovarian carcinoma. However, the influence of carcinomatosis distribution on prognosis is unknown and the prognostic impact of implant size according to their location is poorly studied. Our objective was to assess the impact of peritoneal carcinomatosis quantitative and qualitative localizations on progression free survival (PFS) in patients with advanced epithelial ovarian carcinoma (AEOC) after complete cytoreductive surgery. METHODS: We conducted a monocentric cohort study, retrospective from October 2001 to July 2014. Inclusion criteria were high-grade AEOC patients without residual disease (CC0) after primary debulking surgery (PDS) or after interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Peritoneal carcinomatosis was assessed according to qualitative criteria and quantitative criteria. RESULTS: One hundred and one patients were included. Median PFS was 21·2 months and median OS was 62·2 months. On the whole population, involvement of adipocytes-enriched areas tended to be associated with a decreased PFS and was significantly associated with a decreased OS. Any localization was associated with PFS or OS in the "IDS" subgroup. In the "PDS" subgroup, PCI score and involvement of the right mesocolic area were associated with a decreased PFS. CONCLUSION: Initial tumor load has not been found associated with PFS after complete surgery. Adipocytes-enriched areas and right mesocolic areas involvement were associated with poor prognosis in patients receiving primary debulking surgery. Larger-scale studies are needed to assess whether initial tumor load has a prognostic impact even after complete cytoreductive surgery is achieved.