Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted? Journal Article


Authors: Barlin, J. N.; Long, K. C.; Tanner, E. J.; Gardner, G. J.; Leitao, M. M. Jr; Levine, D. A.; Sonoda, Y.; Abu-Rustum, N. R.; Barakat, R. R.; Chi, D. S.
Article Title: Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted?
Abstract: Objectives To determine if extensive upper abdominal surgery (UAS) affected overall survival (OS) in patients left with ≤ 1 cm but visible residual disease after undergoing primary cytoreductive surgery for ovarian cancer. Our secondary objective was to determine if leaving ≤ 1 cm but visible residual throughout the small bowel (SB) conferred a worse prognosis. Methods All stage IIIB-IV ovarian cancer patients who had visible but ≤ 1 cm residual disease at time of primary cytoreductive surgery from 2001 to 2010 were identified. Extensive UAS procedures and residual SB involvement were recorded. Results The 219 patients identified with ≤ 1 cm but visible residual disease had a median OS of 51 months. In this cohort, 127 had extensive UAS performed, and 87 had residual disease involving the SB. Univariate OS analysis was performed. There was no significant difference in OS between patients who did or did not have extensive UAS (45 vs. 52 months, P = 0.56), or between patients with or without residual SB disease (45 vs. 51 months, P = 0.84). Factors that were significantly associated with OS were age, ASA score, family history, and stage. Conclusions Patients cytoreduced to ≤ 1 cm but visible residual disease who required UAS did not have a worse OS than those who did not require UAS. OS was similar if residual disease involved the SB or not. For ovarian cancer patients with disease not amenable to complete gross resection, extensive surgery should still be considered to achieve ≤ 1 cm but visible residual disease status, including cases where the residual disease involves the SB. © 2013 Elsevier Inc. All rights reserved.
Keywords: adult; cancer survival; aged; aged, 80 and over; middle aged; major clinical study; overall survival; cancer patient; neoplasm staging; ovarian cancer; cytoreductive surgery; ovarian neoplasms; ovary cancer; age; disease severity; abdomen; minimal residual disease; neoplasm, residual; family history; cancer size; abdominal surgery; small intestine; upper abdominal surgery; small bowel; ovarian cancer overall survival extensive surgery small bowel; extensive surgery
Journal Title: Gynecologic Oncology
Volume: 130
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2013-08-01
Start Page: 284
End Page: 288
Language: English
DOI: 10.1016/j.ygyno.2013.05.006
PROVIDER: scopus
PUBMED: 23672929
DOI/URL:
Notes: --- - "Export Date: 1 August 2013" - "CODEN: GYNOA" - "Source: Scopus"
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MSK Authors
  1. Ginger J Gardner
    270 Gardner
  2. Richard R Barakat
    629 Barakat
  3. Dennis S Chi
    707 Chi
  4. Yukio Sonoda
    472 Sonoda
  5. Douglas A Levine
    380 Levine
  6. Mario Leitao
    575 Leitao
  7. Joyce Nuqui Barlin
    23 Barlin
  8. Edward James Tanner
    40 Tanner