Transactions of the 67th Annual Meeting of the South Atlantic Association of Obstetricians and GynecologistsPredictors of suboptimal surgical cytoreduction in women treated with initial cytoreductive surgery for advanced stage epithelial ovarian cancer
Section snippets
Material and methods
The Human Investigations Committee at the University of Virginia approved this study. The Tumor Registry provided a list of all patients who underwent surgery at our institution for FIGO stage III or IV epithelial ovarian cancer between January 1, 1995 to January 1, 2003. Two hundred fifty-two patients were identified. Seven patients were excluded for incomplete medical records, 6 patients for stage I or II disease, 26 patients for surgery at another institution, and 13 patients for receiving
Results
Pathologic data is shown in Table I. Optimal cytoreduction was achieved in 29 women (52%), and 27 women (48%) had suboptimal surgical cytoreduction. Mean age for the entire population was 64 years (range 38 to 86). Forty-five patients (80%) had serous histology, 93% had stage III disease, and 67% had grade 3 disease. The 1 patient with stage IIIA disease had an optimal result. The 3 stage IIIB patients with suboptimal results all had disease at the diaphragm. There was no difference between the
Comment
Ovarian carcinoma is the leading cause of morbidity and mortality from gynecologic malignancies in the US. Contemporary surgical treatment for advanced stage epithelial ovarian cancer includes optimal surgical cytoreduction of tumor to <1 cm. However, at the time of diagnosis, approximately two thirds of women have advanced stage III or IV disease and, despite advances in surgical technique, this extensive tumor volume and distribution make the achievement of an optimal surgical cytoreduction
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Cited by (30)
Diagnostic value of imaging (ultrasonography, doppler, CT, MR, PET-CT) for the diagnosis of a suspicious ovarian mass and staging of ovarian, tubal or primary peritoneal cancer: Article drafted from the French Guidelines in oncology entitled “Initial management of patients with epithelial ovarian cancer” developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY under the aegis of CNGOF and endorsed by INCa
2019, Gynecologie Obstetrique Fertilite et SenologieNeoadjuvant chemotherapy in gynaecological cancers - Implications for staging
2015, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :However, false-positive rates of CT scan to predict surgical outcome can be as high as 60% when a single site is taken into account [6]. Few major studies, their sensitivity, specificity, positive predictive value and negative predictive value are given in Table 4 [18–24]. Suidan et al. recently reported results of a prospective, non-randomized trial of two centres involving 669 patients.
To predict or not to predict? The dilemma of predicting the risk of suboptimal cytoreduction in ovarian cancer
2011, Annals of OncologyCitation Excerpt :Lastly, serum biomarkers, such as CA125, can be used to predict resectability. Predicting resectability based on CA125 was first suggested by Chi et al. [14] and led many researchers to investigate the hypothesis in their own patient populations [27, 38, 44–57]. Kang et al. summarized these results in a recent meta-analysis and concluded that serum CA125 has a sensitivity of 69% and specificity of 63% at a cut-off of 500 IU/ml [37].
A contemporary analysis of the ability of preoperative serum CA-125 to predict primary cytoreductive outcome in patients with advanced ovarian, tubal and peritoneal carcinoma
2009, Gynecologic OncologyCitation Excerpt :Our hypothesis at the time was not that all patients with preoperative serum CA-125 values over 500 U/mL were absolutely unable to be optimally cytoreduced, but that perhaps the higher the preoperative serum CA-125 value, the larger the tumor burden, and consequently the higher the likelihood that tumor would implant in “unresectable” locations such as the porta hepatis, splenic hilum, or other upper abdominal areas. This initial study led several authors to investigate the ability of preoperative CA-125 levels to predict cytoreductive outcomes at their institutions [17–30]. As described by Bristow, however, the issue of “optimal cytoreduction” is a “moving target” [31].
Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma
2008, American Journal of Obstetrics and GynecologyColon resection for ovarian cancer: Intraoperative decisions
2008, Gynecologic Oncology
Presented at the Sixty-Seventh Annual Meeting of the South Atlantic Association of Obstetricians and Gynecologists, January 22-25, 2005, White Sulphur Springs, WVa.