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 <4. Surgical and survival outcome were evaluated by univariate and multivariate analysis.Results: Among 348 consecutive patients, almost half (48.0 %) had an HTL. Among 165 cases receiving PDS, residual tumor (RT) was as follows: no gross residual in 102 patients (61.8 %); RT ≤1 cm in 48 patients (29.1 %) and RT >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.

Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience / Vizzielli, G.; Costantini, B.; Tortorella, L.; Petrillo, M.; Fanfani, F.; Chiantera, V.; Ercoli, A.; Iodice, R.; Scambia, G.; Fagotti, A.. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - 21:12(2014), pp. 3970-3977. [10.1245/s10434-014-3783-6]

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

Petrillo M.;
2014

Abstract

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 <4. Surgical and survival outcome were evaluated by univariate and multivariate analysis.Results: Among 348 consecutive patients, almost half (48.0 %) had an HTL. Among 165 cases receiving PDS, residual tumor (RT) was as follows: no gross residual in 102 patients (61.8 %); RT ≤1 cm in 48 patients (29.1 %) and RT >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.
Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience / Vizzielli, G.; Costantini, B.; Tortorella, L.; Petrillo, M.; Fanfani, F.; Chiantera, V.; Ercoli, A.; Iodice, R.; Scambia, G.; Fagotti, A.. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - 21:12(2014), pp. 3970-3977. [10.1245/s10434-014-3783-6]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11388/245875
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 34
  • ???jsp.display-item.citation.isi??? 32
social impact