Prognostic value of peritoneal scar-like tissue in patients with peritoneal metastases of ovarian origin presenting for curative-intent cytoreductive surgery

World Journal of Surgical Oncology

Research

Laura Polastro¹  Pieter Demetter²  Etienne El Helou³  Ali Bohlok³  Isabelle Veys³  Gabriel Liberale³  Antoine El Asmar³  Florin Pop³ 

[1]Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

[2]Department of Pathology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

[3]Department of Surgical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, 90 Rue Meylemeersch, 1070, Brussels, Belgium

关键词: Ovarian cancer;    Peritoneal carcinomatosis;    Peritoneal fibroses;    Cytoreductive surgery;    Prognostic factors;   

DOI  :  10.1186/s12957-023-03153-z

 received in 2023-06-26, accepted in 2023-08-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundComplete cytoreductive surgery (CRS), remain the gold standard in the treatment of peritoneal metastases of ovarian cancer (PMOC). Given the increasing rate of neoadjuvant chemotherapy in patients with high PCI, prior abdominal surgeries, inflammation and fibrotic changes, the benefit of removing any “peritoneal scar-like tissues” (PST) during CRS, hasn’t been thoroughly investigated. Our objective in this retrospective cohort was to identify the proportion of malignant cells positivity in PST of patients with PMOC, undergoing curative-intent CRS ± HIPEC.MethodsThis is a retrospective study, conducted at our comprehensive cancer center, including patients with PMOC, presenting for curative-intent CRS. During CRS, benign-looking peritoneal lesions, lacking the typical hard nodular, aggressive, and invasive morphology, were systematically resected or electro fulgurated. PSTs were analyzed for the presence of tumoral cells by our pathologist. Correlations between the presence of PST and their positivity, and the different patients’ variables, were studied.ResultsIn 51% of patients, PST harbored malignant cells. Those were associated with poorly differentiated serous tumors, a high PCI (> 8) and a worse DFS: 17 months in the positive PST group versus 29 months in the negative PST group (p = 0.05), on univariate analysis. Multivariate analysis revealed that PCI > 8 and poorly differentiated primary tumor histology were correlated with a worse DFS, and that higher PCI and advanced FIGO were correlated with a worse OS.ConclusionBenign-looking PST harbors malignancy in 51% of cases. The benefit of their systematic resection and their prognostic value should be further investigated in larger cohorts.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 3