Video-assisted thoracic surgery (VATS) evaluation of pleural effusions in patients with newly diagnosed advanced ovarian carcinoma can influence the primary management choice for these patients Journal Article

  

Authors:	Diaz, J. P.; Abu-Rustum, N. R.; Sonoda, Y.; Downey, R. J.; Park, B. J.; Flores, R. M.; Chang, K.; Leitao, M. M. Jr; Barakat, R. R.; Chi, D. S.
Article Title:	Video-assisted thoracic surgery (VATS) evaluation of pleural effusions in patients with newly diagnosed advanced ovarian carcinoma can influence the primary management choice for these patients
Abstract:	Objectives: To assess the utility of thoracoscopy in defining the extent of intrathoracic disease and survival outcomes in patients with moderate to large pleural effusions at the time of diagnosis of advanced ovarian carcinoma. Methods: We reviewed the records of all patients with untreated advanced ovarian carcinoma and moderate to large pleural effusions who underwent video-assisted thoracoscopic surgery (VATS) our institution between 6/01 and 10/08. Demographic, clinicopathologic and outcome data were collected for all patients with a final diagnosis of ovarian carcinoma. Results: Forty-two patients met eligibility criteria, with a median age of 58 years; median CA-125 level of 1747 U/mL; and medium serum albumin of 3.9 g/dl. VATS was performed for right-sided effusions in 30 patients (71%). Macroscopic pleural disease was found in 29 patients (69%). Of the 11 patients with negative cytology, macroscopic pleural disease was found in 4 (36%). Intrathoracic cytoreductive surgery was performed in 6 (33%) of the 18 patients with intrathoracic disease > 1 cm. After VATS, 29/42 (69%) patients underwent attempted primary abdominal surgical debulking. Thirteen patients (31%) received neoadjuvant chemotherapy. Twelve (92%) of these patients underwent interval cytoreductive surgery. Patients who were directed after VATS to neoadjuvant chemotherapy instead of primary surgical cytoreduction had a 2-year PFS rate of 22% compared to 42% for the primary cytoreductive group (P = 0.36). Conclusions: Overall, management was altered based on VATS findings in 43% of cases. Further investigation is needed to define the prognostic significance of VATS evaluation of the burden of pleural disease. © 2009 Elsevier Inc. All rights reserved.
Keywords:	survival; adult; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; advanced cancer; adjuvant therapy; antineoplastic agent; cancer diagnosis; cytoreductive surgery; ovarian neoplasms; cytology; demography; medical record review; adjuvant chemotherapy; ovary carcinoma; pleura effusion; ca 125 antigen; pleural effusion, malignant; thorax surgery; thoracic surgery, video-assisted; thorax disease; pleural neoplasms; vats; thoracoscopy; advanced ovarian carcinoma; pleural disease; thracoscopy; serum albumin; pleura disease
Journal Title:	Gynecologic Oncology
Volume:	116
Issue:	3
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2010-03-01
Start Page:	483
End Page:	488
Language:	English
DOI:	10.1016/j.ygyno.2009.09.047
PUBMED:	19945741
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-75749083965&partnerID=40&md5=4ea1b494cdd1aa9a0d12171bb40eea35
Notes:	--- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus"

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