Beyond tertiary cytoreduction in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer Journal Article
| Authors: | Shih, K. K.; Chi, D. S.; Barakat, R. R.; Leitao, M. M. Jr |
| Article Title: | Beyond tertiary cytoreduction in patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer |
| Abstract: | Background: Primary, secondary, and possibly tertiary surgical cytoreduction in patients with recurrent epithelial ovarian (EOC), fallopian tube (FTC), or primary peritoneal (PPC) cancer appears to be associated with a survival benefit. The objective of this study was to assess if cytoreduction of recurrences after tertiary cytoreduction offers any potential benefit in these patients. Methods: We performed a retrospective chart review of all patients with recurrent EOC, FTC, or PPC who underwent additional cytoreductive procedures after a prior tertiary cytoreduction (quaternary cytoreduction) at our institution between 1991 and 2008. Disease-specific survival (DSS) was calculated from the time of quaternary cytoreduction to last follow-up. Univariate analyses were used to analyze outcomes and to identify potential prognostic factors. Results: A total of 15 patients were identified, of which 7 (47%) have died of disease. All patients had undergone prior optimal secondary and tertiary surgical cytoreductive procedures. The size of residual disease varied from 0 (in 10 cases/67%) to > 1 cm (in 2 cases, 13%). Residual disease (≤ 1 cm vs > 1 cm) and number of recurrence sites (single vs multiple) were found to be significant prognostic factors on univariate analysis. Conclusions: Cytoreductive surgery beyond tertiary cytoreduction may be a reasonable option in highly select patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer, especially in the setting of a single site of recurrent disease. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; aged; middle aged; antibiotic agent; cancer surgery; survival rate; retrospective studies; cancer localization; cancer recurrence; adjuvant therapy; cancer patient; disease free survival; neoplasm staging; cytoreductive surgery; ovarian neoplasms; ovary cancer; peritoneum cancer; neoplasm recurrence, local; peritoneal neoplasms; abdominal abscess; medical record review; cancer mortality; minimal residual disease; epithelial cells; jaundice; gynecologic surgical procedures; platinum derivative; bile duct obstruction; uterine tube carcinoma; fallopian tube neoplasms; epithelial ovarian cancer; wound infection; ileus; cellulitis; fallopian tube cancer; primary peritoneal cancer; vagina bleeding; tertiary cytoreduction; quarternary cytoreduction; colon fistula; cystocolic fistula |
| Journal Title: | Gynecologic Oncology |
| Volume: | 116 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-03-01 |
| Start Page: | 364 |
| End Page: | 369 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2009.10.047 |
| PUBMED: | 19897231 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus" |
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