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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2014

01-11-2014 | Gynecologic Oncology

Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience

Authors: Giuseppe Vizzielli, MD, Barbara Costantini, MD, Lucia Tortorella, MD, Marco Petrillo, MD, Francesco Fanfani, MD, Vito Chiantera, MD, Alfredo Ercoli, PhD, Raffaella Iodice, MD, Giovanni Scambia, MD, Anna Fagotti, PhD

Published in: Annals of Surgical Oncology | Issue 12/2014

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Abstract

Purpose

The aim of this study was to investigate whether preoperative laparoscopic evaluation of the dissemination of disease may have an independent impact on survival in advanced epithelial ovarian cancer (AEOC).

Methods

All AEOC women were submitted to staging laparoscopy before receiving primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT). All study women received a laparoscopic score (predictive index value [PIV]) and were stratified into three groups based on volume of disease: high tumor load (HTL) for PIV ≥8, intermediate tumor load (ITL) for PIV equal to 6 and 4, and low tumor load (LTL) for PIV <4. Surgical and survival outcome were evaluated by univariate and multivariate analysis.

Results

Among 348 consecutive patients, almost half (48.0 %) had an HTL. Among 165 cases receiving PDS, residual tumor (RT) was as follows: no gross residual in 102 patients (61.8 %); RT ≤1 cm in 48 patients (29.1 %) and RT >1 cm in 15 cases (9.1 %). When stratifying the whole population according to laparoscopic tumor load, the median progression-free survival (PFS) was 33 months for LTL, 18 months for ITL, and 14 months for HTL (p = 0.0001). The median overall survival (OS) with respect to laparoscopic PIV was not reached for LTL, whereas it was 47 months for ITL and 33 months for HTL, respectively (p = 0.0001). At multivariate analysis, tumor load stratified by PIV retained an independent prognostic value on PFS and OS, together with RT and performance status.

Conclusions

RT remains an important prognostic factor in patients with AEOC, but tumor dissemination can play a role in determining prognosis in these women.
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Metadata
Title
Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience
Authors
Giuseppe Vizzielli, MD
Barbara Costantini, MD
Lucia Tortorella, MD
Marco Petrillo, MD
Francesco Fanfani, MD
Vito Chiantera, MD
Alfredo Ercoli, PhD
Raffaella Iodice, MD
Giovanni Scambia, MD
Anna Fagotti, PhD
Publication date
01-11-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 12/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3783-6

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