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Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: A retrospective study
Author(s) -
Nagasaka Kazunori,
Kawana Kei,
Tomio Kensuke,
Tsuruga Tetsushi,
MoriUchino Mayuyo,
Miura Shiho,
Tanikawa Michihiro,
Miyamoto Yuichiro,
Ikeda Yuji,
Sone Kenbun,
Adachi Katsuyuki,
Matsumoto Yoko,
Arimoto Takahide,
Oda Katsutoshi,
Osuga Yutaka,
Fujii Tomoyuki
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12616
Subject(s) - medicine , debulking , chemotherapy , stage (stratigraphy) , univariate analysis , ovarian cancer , cytology , surgery , multivariate analysis , cancer , oncology , pathology , paleontology , biology
Aim The purpose of our study is to investigate clinically significant prognostic factors at the time of interval surgery ( IS ), comprising interval look surgery and interval debulking surgery, for T3c ( I nternational F ederation of G ynecology and O bstetrics stage IIIc to IV ) advanced ovarian cancer ( AOC ) patients during primary treatment. Methods We reviewed records of patients with T3c AOC who underwent IS following neoadjuvant chemotherapy or up‐front primary debulking surgery with adjuvant chemotherapy at our institution between J anuary 1996 and D ecember 2010. For analysis of prognostic factors, cytology of peritoneal exfoliative cells at IS was added to clinicopathological variables. Results A retrospective analysis was performed on 50 cases. The median age was 61.1 years (range, 38–78), with median follow‐up of 45.9 months (range, 12–122). Macroscopic tumors were completely resected in 32 cases (64%) at IS . Univariate analyses of clinicopathological factors for IS identified preoperative serum cancer antigen‐125 levels (≥20 IU /mL; P = 0.0539), number of residual lesions at IS (≥20; P = 0.0554), incomplete surgery at IS ( P = 0.0171) and positive peritoneal cytology at IS ( P = 0.0015) as significant factors for prognosis regarding progression‐free survival ( PFS ). Multivariate analysis identified positive peritoneal cytology ( P = 0.0303) as a unique independent predictor of poor prognosis in PFS . Conclusion Positive peritoneal cytology at IS appears to be a significant factor for poor prognosis in PFS , which may provide useful information for post‐ IS chemotherapy planning. IS in the treatment of AOC may be useful for not only complete resection, but also for identification of patients with poor prognosis.