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The clinical significance of malignant pleural effusions in patients with optimally debulked ovarian carcinoma
Author(s) -
Eitan Ram,
Levine Douglas A.,
AbuRustum Nadeem,
Sonoda Yukio,
Huh Jae N.,
Franklin Corinna C.,
Stevens Tobey A.,
Barakat Richard R.,
Chi Dennis S.
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20920
Subject(s) - medicine , stage (stratigraphy) , ascites , ovarian carcinoma , carcinoma , pleural effusion , malignant pleural effusion , surgery , chemotherapy , survival rate , retrospective cohort study , gastroenterology , ovarian cancer , cancer , paleontology , biology
BACKGROUND The objective of this study was to determine the impact of malignant pleural effusions on survival in patients with optimally debulked, advanced epithelial ovarian carcinoma. METHODS The authors conducted a retrospective review of all patients with advanced epithelial ovarian carcinoma who underwent optimal primary cytoreduction at their institution between January 1987 and August 2000. Survival rates were compared between patients with optimally debulked Stage IIIC epithelial ovarian carcinoma and patients with optimally debulked Stage IV epithelial ovarian carcinoma (according to the International Federation of Gynecology and Obstetrics [FIGO] staging system) based on cytology‐proven malignant pleural effusions. RESULTS Ninety‐nine patients were identified, and 97 of those patients were evaluable. The group with Stage IIIC disease included 76 patients, and the group with Stage IV disease included 21 patients. The median age at diagnosis was 55 years (range, 26–88 years). The majority of patients received platinum‐based chemotherapy after undergoing optimal primary cytoreduction. Age, tumor grade and histology, and the percentage of patients with ascites were similar in the two groups. The median survival rate was 58 months for patients who had Stage IIIC disease and 30 months for patients who had Stage IV disease ( P = 0.016). CONCLUSIONS Although both groups underwent optimal cytoreduction in the abdomen/pelvis and were treated in a similar fashion, the median survival rate of patients with malignant pleural effusions was significantly shorter than the survival of patients without effusions. Many factors that led to or were manifested by pleural effusions, such as undetected bulky residual intrathoracic disease, may have been the cause for this survival difference. In the patients with effusions, one or more of these contributing factors may have led to the observed decreased survival rate, warranting further investigation. Cancer 2005. © 2005 American Cancer Society.