Patterns of diaphragm involvement in stage 3B/3C ovarian–tubal–peritoneal epithelial cancer patients and survival outcomes
- 28 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archiv für Gynäkologie
- Vol. 303 (1), 241-248
- https://doi.org/10.1007/s00404-020-05802-0
Abstract
Purpose Demonstrate survival outcomes of stage 3B/3C ovarian–tubal–peritoneal epithelial cancer patients who had metastases on diaphragm. Methods 141 patients who had undergone diaphragm surgery as a part of primary cytoreductive surgery procedures performed for stage 3B and 3C ovarian–tubal–peritoneal epithelial cancers were reviewed retrospectively. Patients who were administered neoadjuvant chemotherapy and patients who were suboptimally cytoreduced were not included to the study. Results Median follow-up time was 42 months. Median overall survival of the patients who underwent diaphragm full-thickness resection (n = 18) because of tumors infiltrating diaphragm muscle was 40 months. Median overall survival of the patients who did not have a transdiaphragmatic thoracotomy (n = 113) was 77 months. Patients who underwent a willful full-thickness diaphragm resection because of tumors invading diaphragm muscle had significantly shorter survival compared with patients who did not have a transdiaphragmatic thoracotomy (p = 0.033). Seven (38.9%) of the 18 patients who underwent diaphragm full-thickness resection developed a recurrence in thorax. Twelve (9.8%) of the remaining 123 patients developed a recurrence in thorax. Patients who underwent full-thickness diaphragm resection because of tumors infiltrating diaphragm muscle developed recurrence in the thorax more frequently (p = 0.001). Conclusions Diaphragm muscle involvement is a predictor of thorax recurrences and worse survival outcomes in stage 3B and 3C ovarian–tubal–peritoneal epithelial cancers. Thus, this should be considered when selecting appropriate adjuvant treatment and route of administration (intravenous/intraperitoneal) in patients who had diaphragm implants infiltrating diaphragm muscle.Keywords
This publication has 21 references indexed in Scilit:
- Diaphragmatic surgery during cytoreduction for primary or recurrent epithelial ovarian cancer: a review of the literatureArchiv für Gynäkologie, 2013
- Diaphragmatic Surgery During Primary Cytoreduction for Advanced Ovarian Cancer: Peritoneal Stripping Versus Diaphragmatic ResectionInternational Journal of Gynecologic Cancer, 2011
- Upper abdominal surgery in advanced and recurrent ovarian cancer: Role of diaphragmatic surgeryGynecologic Oncology, 2010
- Prognostic Factors for Stage III Epithelial Ovarian Cancer: A Gynecologic Oncology Group StudyJournal of Clinical Oncology, 2007
- What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)?Gynecologic Oncology, 2006
- Surgical treatment of diaphragm disease correlates with improved survival in optimally debulked advanced stage ovarian cancerGynecologic Oncology, 2006
- Intraperitoneal Cisplatin and Paclitaxel in Ovarian CancerNew England Journal of Medicine, 2006
- Phase III Trial of Carboplatin and Paclitaxel Compared With Cisplatin and Paclitaxel in Patients With Optimally Resected Stage III Ovarian Cancer: A Gynecologic Oncology Group StudyJournal of Clinical Oncology, 2003
- Procedures Required to Accomplish Complete Cytoreduction of Ovarian Cancer: Is There a Correlation with “Biological Aggressiveness” and Survival?Gynecologic Oncology, 2001
- A study of the three-dimensional organization of the human diaphragmatic lymphatic lacunae and lymphatic drainage unitsAnnals of Anatomy - Anatomischer Anzeiger, 1996