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Patterns of diaphragm involvement in stage 3B/3C ovarian–tubal–peritoneal epithelial cancer patients and survival outcomes

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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Funding

This study has received no financial support.

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Authors and Affiliations

  1. Gynecological Oncology Department, University of Health Sciences, Etlik Zubeyde Hanim Women’s Health Teaching and Research Hospital, Etlik Street, Ankara, 06010, Turkey

    Yasin Durmuş, Esra İşçi Bostancı, Ayşe Sinem Duru Çöteli, Mehmet Ünsal, Fulya Kayıkçıoğlu & Nurettin Boran

Authors
  1. Yasin Durmuş
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  2. Esra İşçi Bostancı
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  3. Ayşe Sinem Duru Çöteli
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  4. Mehmet Ünsal
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  5. Fulya Kayıkçıoğlu
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  6. Nurettin Boran
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Contributions

YD: study design, conceptualization, investigation, data collection, statistical analysis, writing—original draft, writing—review and editing. EİB: writing—review and editing. ASDÇ: data collection. MÜ: data collection. FK: validation, statistical analysis, writing—review and editing. NB: validation, statistical analysis, writing—review and editing.

Corresponding author

Correspondence to Yasin Durmuş.

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Conflict of interest

The authors declare that none of them has any potential conflict of interest with respect to the subject of this manuscript.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board approval was received for this study. (Approval date and number: 22.03.2019/90057706–799-E.212).

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Signed informed consent for anonymous publication of disease related information was obtained from each patient.

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Durmuş, Y., İşçi Bostancı, E., Duru Çöteli, A.S. et al. Patterns of diaphragm involvement in stage 3B/3C ovarian–tubal–peritoneal epithelial cancer patients and survival outcomes. Arch Gynecol Obstet 303, 241–248 (2021). https://doi.org/10.1007/s00404-020-05802-0

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  • DOI: https://doi.org/10.1007/s00404-020-05802-0

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