Valerio Gallotta1, Carmine Conte2, Marco D'Indinosante3, Ettore Capoluongo4, Angelo Minucci5, Agostino Maria De Rose6, Francesco Ardito6, Felice Giuliante6, Andrea Di Giorgio7, Gian Franco Zannoni8, Anna Fagotti9, Christian Margreiter10, Giovanni Scambia9, Gabriella Ferrandina9. 1. Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy. Electronic address: gallottav@gmail.com. 2. Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy. 3. Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Roma, Italy. 4. Laboratory of Clinical Molecular and Personalized Diagnostics, Catholic University of the Sacred Heart, Roma, Italy; Laboratory of Clinical Molecular and Personalized Diagnostics, Fondazione "Policlinico Universitario A. Gemelli" IRCCS, Rome, Italy. 5. Laboratory of Clinical Molecular and Personalized Diagnostics, Fondazione "Policlinico Universitario A. Gemelli" IRCCS, Rome, Italy. 6. Department of Surgical Sciences, Hepatobiliary Unit, Fondazione "Policlinico Universitario A. Gemelli", IRCCS, Catholic University of the Sacred Heart, Rome, Italy. 7. Division of General Surgery, Fondazione "Policlinico Universitario A. Gemelli", IRCCS, Rome, Italy. 8. Institute of Histopathology, Fondazione "Policlinico Universitario A. Gemelli", IRCCS, Catholic University of the Sacred Heart, Roma, Italy. 9. Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy; Università Cattolica del Sacro Cuore, Istituto di Ginecologia e Ostetricia, Roma, Italy. 10. Department of Visceral, Transplant, and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Abstract
OBJECTIVE: To describe accurately the oncological outcomes after hepatic resection (HR) in recurrent ovarian carcinoma (ROC) evaluating clinic-pathological variables and mutational status of BRCA1/2. Although HR is considered a challenging situation in ROC patients, assessment of BRCA1/2 mutational status seems to have a relevant clinical value to guide surgical therapy. METHODS: Patients who underwent HR for ROC at the Catholic University of Rome, between June 2012 and October 2017 were included. Exclusion criteria were represented by extra-abdominal disease and presence of diffuse peritoneal carcinomatosis requiring more than 2 bowel resections. Details relative to HR were collected and BRCA analysis was performed. Predictive factors of post-HR progression free survival (PHR-PFS) were assessed by univariate analyses using Cox-proportional hazard regression models. RESULTS: Thirty-four patients undewent HR within secondary cytoreductive surgery (SCS). Six patients (17.6%) presented with hepatic relapse only, while the remaining 28 patients (82.4%) had concomitant extra-hepatic disease. In the whole series, the 3-yr PHR-PFS was 49.1% and the 3-yr post-HR overall survival was 72.9%. Univariate analysis of variables conditioning PHR-PFS showed that only BRCA mutational status played a statistically significant favourable role: the 3-yr PHR-PFS rate was 81.0% in BRCA mutated patient compared to 15.2% in wild type ones (p value: 0.001). CONCLUSIONS: Our clinical analyses suggest that in ROC patients with liver disease the assessment of germline and somatic BRCA mutational status can help to select patients elegible for SCS.
OBJECTIVE: To describe accurately the oncological outcomes after hepatic resection (HR) in recurrent ovarian carcinoma (ROC) evaluating clinic-pathological variables and mutational status of BRCA1/2. Although HR is considered a challenging situation in ROC patients, assessment of BRCA1/2 mutational status seems to have a relevant clinical value to guide surgical therapy. METHODS:Patients who underwent HR for ROC at the Catholic University of Rome, between June 2012 and October 2017 were included. Exclusion criteria were represented by extra-abdominal disease and presence of diffuse peritoneal carcinomatosis requiring more than 2 bowel resections. Details relative to HR were collected and BRCA analysis was performed. Predictive factors of post-HR progression free survival (PHR-PFS) were assessed by univariate analyses using Cox-proportional hazard regression models. RESULTS: Thirty-four patients undewent HR within secondary cytoreductive surgery (SCS). Six patients (17.6%) presented with hepatic relapse only, while the remaining 28 patients (82.4%) had concomitant extra-hepatic disease. In the whole series, the 3-yr PHR-PFS was 49.1% and the 3-yr post-HR overall survival was 72.9%. Univariate analysis of variables conditioning PHR-PFS showed that only BRCA mutational status played a statistically significant favourable role: the 3-yr PHR-PFS rate was 81.0% in BRCA mutated patient compared to 15.2% in wild type ones (p value: 0.001). CONCLUSIONS: Our clinical analyses suggest that in ROC patients with liver disease the assessment of germline and somatic BRCA mutational status can help to select patients elegible for SCS.
Authors: Gregory W Kirschen; Samantha M Dayton; Sophia Blakey-Cheung; Michael L Pearl Journal: Clin Exp Obstet Gynecol Date: 2021-02-15 Impact factor: 0.146