A novel algorithm for the treatment strategy for advanced epithelial ovarian cancer: consecutive imaging, frailty assessment, and diagnostic laparoscopy

BMC Cancer

Research Article

Young Tae Kim¹  Jung-Yun Lee¹  Sunghoon Kim¹  Jung Won Yoon¹  Eun Ji Nam¹  Kyung Jin Eoh¹  Sang Wun Kim¹ 

[1] Department of Obstetrics and Gynecology, Institute of Women’s Medical Life Science, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea;

关键词: Epithelial ovarian cancer;    Laparoscopy;    Cytoreduction surgical procedures;    Debulking surgical procedures;   

DOI  :  10.1186/s12885-017-3476-1

 received in 2016-10-19, accepted in 2017-07-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThis study aimed to evaluate the perioperative outcomes and prognostic impact of the consecutive steps of imaging, frailty assessment, and diagnostic laparoscopy (DLS) in patients with advanced epithelial ovarian cancer (EOC).MethodsPatients diagnosed with EOC during 2012–2015 were analyzed retrospectively. Surgical and survival outcomes were compared between three treatment groups: patients without high tumor dissemination (HTD) who underwent primary debulking surgery (PDS group); patients with HTD who underwent DLS (DLS group); and patients with HTD diagnosed by cytological confirmation of malignancy followed by neoadjuvant chemotherapy (NACT group).ResultsOf 181 patients, 85, 38, and 58 underwent PDS, DLS, and NACT, respectively. Among the 38 consecutive patients who initially underwent DLS, 6 were considered suitable for PDS; the remaining 32 were eligible for NACT followed by interval debulking surgery. The median operative times of debulking surgery in the PDS, DLS, and NACT groups were 365 min (interquartile range [IQR]: 216.5–476.5 min), 266.2 min (IQR: 160.3–193.5 min), and 339.0 min (IQR: 205–425 min; P = 0.042), respectively, with respective median estimated blood loss volumes of 962.2 mL (IQR: 300–1037.5 mL), 267.1 mL (IQR: 150–450 mL), and 861.7 mL (IQR: 150–1200 mL; P = 0.023). The DLS group had significantly reduced transfusion requirements and intensive care unit admission rates (P = 0.006). The Kaplan–Meier survival analysis indicated significantly poor PFS in the NACT group. However, there was no significant difference in OS among the three groups.ConclusionsThe consecutive steps of imaging, frailty assessment, and DLS might facilitate rapid assessments of peritoneal disease extent and resectability; this novel algorithm might also be used to individualize treatment.

【 授权许可】

CC BY   
© The Author(s). 2017