Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: A retrospective study

Aim The purpose of our study is to investigate clinically significant prognostic factors at the time of interval surgery (IS), comprising interval look surgery and interval debulking surgery, for T3c (International Federation of Gynecology and Obstetrics stage IIIc to IV) advanced ovarian cancer (AO...

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Published in:The journal of obstetrics and gynaecology research 2015-05, Vol.41 (5), p.755-762
Main Authors: Nagasaka, Kazunori, Kawana, Kei, Tomio, Kensuke, Tsuruga, Tetsushi, Mori‐Uchino, Mayuyo, Miura, Shiho, Tanikawa, Michihiro, Miyamoto, Yuichiro, Ikeda, Yuji, Sone, Kenbun, Adachi, Katsuyuki, Matsumoto, Yoko, Arimoto, Takahide, Oda, Katsutoshi, Osuga, Yutaka, Fujii, Tomoyuki
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy, Adjuvant
Cytoreduction Surgical Procedures
Disease-Free Survival
Female
Humans
interval surgery
Middle Aged
Neoplasm Staging
ovarian cancer
Ovarian Neoplasms - drug therapy
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
peritoneal cytology
Peritoneum - pathology
Prognosis
prognostic factor
Retrospective Studies
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Summary:Aim The purpose of our study is to investigate clinically significant prognostic factors at the time of interval surgery (IS), comprising interval look surgery and interval debulking surgery, for T3c (International Federation of Gynecology and Obstetrics stage IIIc to IV) advanced ovarian cancer (AOC) patients during primary treatment. Methods We reviewed records of patients with T3c AOC who underwent IS following neoadjuvant chemotherapy or up‐front primary debulking surgery with adjuvant chemotherapy at our institution between January 1996 and December 2010. For analysis of prognostic factors, cytology of peritoneal exfoliative cells at IS was added to clinicopathological variables. Results A retrospective analysis was performed on 50 cases. The median age was 61.1 years (range, 38–78), with median follow‐up of 45.9 months (range, 12–122). Macroscopic tumors were completely resected in 32 cases (64%) at IS. Univariate analyses of clinicopathological factors for IS identified preoperative serum cancer antigen‐125 levels (≥20 IU/mL; P = 0.0539), number of residual lesions at IS (≥20; P = 0.0554), incomplete surgery at IS (P = 0.0171) and positive peritoneal cytology at IS (P = 0.0015) as significant factors for prognosis regarding progression‐free survival (PFS). Multivariate analysis identified positive peritoneal cytology (P = 0.0303) as a unique independent predictor of poor prognosis in PFS. Conclusion Positive peritoneal cytology at IS appears to be a significant factor for poor prognosis in PFS, which may provide useful information for post‐IS chemotherapy planning. IS in the treatment of AOC may be useful for not only complete resection, but also for identification of patients with poor prognosis.
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.12616