Value of Diaphragmatic Surgery During Interval Debulking Surgery.
|Abstract||The aim of this study was to assess the value of diaphragmatic surgery to achieve optimal debulking in patients with advanced ovarian cancer treated by neoadjuvant chemotherapy (NAC).|
Comparison of treatment invasiveness between upfront debulking surgery versus interval debulking surgery following neoadjuvant chemotherapy for stage III/IV ovarian, tubal, and peritoneal cancers in a phase III randomised trial: Japan Clinical Oncology Group Study JCOG0602.
|Journal Title||anticancer research|
|Publication Year Start||2018-01-01|
PMID- 29277802 OWN - NLM STAT- MEDLINE DCOM- 20180104 LR - 20180104 IS - 1791-7530 (Electronic) IS - 0250-7005 (Linking) VI - 38 IP - 1 DP - 2018 Jan TI - Value of Diaphragmatic Surgery During Interval Debulking Surgery. PG - 411-416 AB - BACKGROUND/AIM: The aim of this study was to assess the value of diaphragmatic surgery to achieve optimal debulking in patients with advanced ovarian cancer treated by neoadjuvant chemotherapy (NAC). PATIENTS AND METHODS: This is a retrospective review of the medical records of 182 patients. Diaphragmatic surgery was performed during interval debulking surgery (IDS) in 74 patients between January 2002 and December 2014. The patients were divided in 2 groups: with or without histological residual diaphragmatic disease. The time-course of serum CA125 levels, cytoreductive outcome, overall survival (OS) and relapse-free survival (RFS) were analyzed. Patients without diaphragmatic peritonectomy (DP) during IDS were included in the survival analysis. RESULTS: One hundred thirty-two (72.5%) patients had FIGO stage III disease and 43 (23.6%) patients had stage IV disease. Histological examination of DP was positive in 45 patients and negative in 29 patients. CA125 normalization after the 3rd cycle of NAC was significantly associated with negative DP. OS tended to be higher in the DP-negative group (37.8 months vs 19 months, p=0.1). Median OS was 40.7 months in the case of IDS without DP and 22 months in the case of IDS with DP (p=0.048). CONCLUSION: Evaluation of residual diaphragmatic disease can be difficult after NAC. The CA125 tumor marker appears to be a useful tool to define the indications for DP. Diaphragmatic surgery after NAC may be of limited value. CI - Copyright(c) 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. FAU - Pelissier, Aurelie AU - Pelissier A AD - Department of Oncologic Surgery, Centre Rene Huguenin, Institut Curie, Saint Cloud, France [email protected] FAU - Franke, Oona AU - Franke O AD - Department of Oncologic Surgery, Centre Rene Huguenin, Institut Curie, Saint Cloud, France. FAU - Darai, Emile AU - Darai E AD - Department of Gynecology, Hopital Tenon, Paris, France. FAU - Houvenaeghel, Gilles AU - Houvenaeghel G AD - Department of Oncologic Surgery, Institut Paoli-Calmettes, Marseille, France. FAU - Chereau, Elisabeth AU - Chereau E AD - Department of Oncologic Surgery, Institut Paoli-Calmettes, Marseille, France. FAU - Rouzier, Roman AU - Rouzier R AD - Department of Oncologic Surgery, Centre Rene Huguenin, Institut Curie, Saint Cloud, France. AD - Versailles-St-Quentin-en-Yvelines University: Risques cliniques et securite en sante des femmes et en sante perinatale, Versailles, France. LA - eng PT - Journal Article PL - Greece TA - Anticancer Res JT - Anticancer research JID - 8102988 RN - 0 (Biomarkers, Tumor) RN - 0 (Interleukin-5 Receptor alpha Subunit) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/therapeutic use MH - Biomarkers, Tumor/*blood MH - Cytoreduction Surgical Procedures/*methods MH - Diaphragm/*surgery MH - Disease-Free Survival MH - Female MH - Humans MH - Interleukin-5 Receptor alpha Subunit/*blood MH - Middle Aged MH - Neoadjuvant Therapy MH - Ovarian Neoplasms/drug therapy/pathology/*surgery MH - Retrospective Studies MH - Survival Analysis MH - Young Adult OTO - NOTNLM OT - *Ovarian carcinoma OT - *diaphragmatic surgery OT - *neoadjuvant chemotherapy EDAT- 2017/12/27 06:00 MHDA- 2018/01/05 06:00 CRDT- 2017/12/27 06:00 PHST- 2017/10/09 00:00 [received] PHST- 2017/10/23 00:00 [revised] PHST- 2017/10/27 00:00 [accepted] PHST- 2017/12/27 06:00 [entrez] PHST- 2017/12/27 06:00 [pubmed] PHST- 2018/01/05 06:00 [medline] AID - 38/1/411 [pii] AID - 10.21873/anticanres.12237 [doi] PST - ppublish SO - Anticancer Res. 2018 Jan;38(1):411-416. doi: 10.21873/anticanres.12237.