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Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study
BACKGROUND: Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent op...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100746/ https://www.ncbi.nlm.nih.gov/pubmed/25328074 http://dx.doi.org/10.1186/1757-2215-7-72 |
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author | Giorda, Giorgio Gadducci, Angiolo Lucia, Emilio Sorio, Roberto Bounous, Valentina E Sopracordevole, Francesco Tinelli, Andrea Baldassarre, Gustavo Campagnutta, Elio |
author_facet | Giorda, Giorgio Gadducci, Angiolo Lucia, Emilio Sorio, Roberto Bounous, Valentina E Sopracordevole, Francesco Tinelli, Andrea Baldassarre, Gustavo Campagnutta, Elio |
author_sort | Giorda, Giorgio |
collection | PubMed |
description | BACKGROUND: Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent optimal cytoreduction. METHODS: Between 1997 and 2004, 301 patients with advanced epithelial cancer underwent surgery at Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute Aviano (PN) Italy. All underwent maximal surgical effort, including bowel and upper abdominal procedure, in order to achieve optimal debulking (R < 0.5 cm). PFS and OS were compared with residual disease, grading and surgical procedures. RESULTS: Optimal cytoreduction was achieved in 244 patients (81.0%); R0 in 209 women (69.4.%) and R < 0.5 in 35 (11.6%). Bowel resection was performed in 116 patients (38.5%): recto-sigmoidectomy alone (69.8%), upper bowel resection only (14.7%) and both recto-sigmoidectomy and other bowel resection (15.5%). Pelvic peritonectomy and upper abdomen procedures were carried out in 202 (67.1%) and 82 (27.2%) patients respectively. Among the 284 patients available for follow-up, PFS and OS were significantly better in patients with R < 0.5. Among the 229 patients with optimal debulking (R < 0.5), 137 patients (59.8%) developed recurrent disease or progression. In the 229 R < 0.5 group, bowel involvement was associated with decreased PFS and OS in G1-2 patients whereas in G3 patients OS, but not PFS, was adversely affected. In the 199 patients with R0, PFS and OS were significantly better (p < 0.01) for G1-2 patients without bowel involvement whereas only significant OS (p < 0.05) was observed in G3 patients without bowel involvement versus G3 patients with bowel involvement. CONCLUSIONS: Optimal cytoreduction (R < 0.5 cm and R0) is the most important prognostic factor for advanced epithelial ovarian cancer. In the optimally cytoreduced (R < 0.5 and R0) patients, bowel involvement is associated with dismal prognosis for OS both in patients with G1-2 grading and in patients with G3 grading. Bowel involvement in G3 patients, carries instead the same risk of recurrence for PFS. |
format | Online Article Text |
id | pubmed-4100746 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41007462014-07-17 Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study Giorda, Giorgio Gadducci, Angiolo Lucia, Emilio Sorio, Roberto Bounous, Valentina E Sopracordevole, Francesco Tinelli, Andrea Baldassarre, Gustavo Campagnutta, Elio J Ovarian Res Research BACKGROUND: Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent optimal cytoreduction. METHODS: Between 1997 and 2004, 301 patients with advanced epithelial cancer underwent surgery at Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute Aviano (PN) Italy. All underwent maximal surgical effort, including bowel and upper abdominal procedure, in order to achieve optimal debulking (R < 0.5 cm). PFS and OS were compared with residual disease, grading and surgical procedures. RESULTS: Optimal cytoreduction was achieved in 244 patients (81.0%); R0 in 209 women (69.4.%) and R < 0.5 in 35 (11.6%). Bowel resection was performed in 116 patients (38.5%): recto-sigmoidectomy alone (69.8%), upper bowel resection only (14.7%) and both recto-sigmoidectomy and other bowel resection (15.5%). Pelvic peritonectomy and upper abdomen procedures were carried out in 202 (67.1%) and 82 (27.2%) patients respectively. Among the 284 patients available for follow-up, PFS and OS were significantly better in patients with R < 0.5. Among the 229 patients with optimal debulking (R < 0.5), 137 patients (59.8%) developed recurrent disease or progression. In the 229 R < 0.5 group, bowel involvement was associated with decreased PFS and OS in G1-2 patients whereas in G3 patients OS, but not PFS, was adversely affected. In the 199 patients with R0, PFS and OS were significantly better (p < 0.01) for G1-2 patients without bowel involvement whereas only significant OS (p < 0.05) was observed in G3 patients without bowel involvement versus G3 patients with bowel involvement. CONCLUSIONS: Optimal cytoreduction (R < 0.5 cm and R0) is the most important prognostic factor for advanced epithelial ovarian cancer. In the optimally cytoreduced (R < 0.5 and R0) patients, bowel involvement is associated with dismal prognosis for OS both in patients with G1-2 grading and in patients with G3 grading. Bowel involvement in G3 patients, carries instead the same risk of recurrence for PFS. BioMed Central 2014-07-09 /pmc/articles/PMC4100746/ /pubmed/25328074 http://dx.doi.org/10.1186/1757-2215-7-72 Text en Copyright © 2014 Giorda et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Giorda, Giorgio Gadducci, Angiolo Lucia, Emilio Sorio, Roberto Bounous, Valentina E Sopracordevole, Francesco Tinelli, Andrea Baldassarre, Gustavo Campagnutta, Elio Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title | Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title_full | Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title_fullStr | Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title_full_unstemmed | Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title_short | Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
title_sort | prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100746/ https://www.ncbi.nlm.nih.gov/pubmed/25328074 http://dx.doi.org/10.1186/1757-2215-7-72 |
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