Advertisement

Journal of Cancer Research and Clinical Oncology

, Volume 142, Issue 7, pp 1509–1520 | Cite as

Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer

  • Maria Luisa Gasparri
  • Giovanni Grandi
  • Daniele Bolla
  • Beat Gloor
  • Sara Imboden
  • Pierluigi Benedetti Panici
  • Michael D. Mueller
  • Andrea PapadiaEmail author
Review – Clinical Oncology

Abstract

Purpose

Surgical cytoreduction remains a cornerstone in the management of patients with advanced and recurrent epithelial ovarian cancer. Parenchymal liver metastases determine stage VI disease and are commonly considered a major limit in the achievement of an optimal cytoreduction. The purpose of this manuscript was to discuss the rationale of liver resection and the morbidity related to this procedure in advanced and recurrent ovarian cancer.

Methods

A search of the National Library of Medicine’s MEDLINE/PubMed database until March 2015 was performed using the keywords: “ovarian cancer,” “hepatic,” “liver,” and “metastases.”

Results

In patients with liver metastases, hepatic resection is associated with a similar prognosis as stage IIIC patients. The length of the disease-free interval between primary diagnosis and occurrence of liver metastases, as well as residual disease after resection, is the most important prognostic factors. In addition, the number of liver lesions, resection margins, and the gynecologic oncology group performance status seem to play also an important role in determining outcome.

Conclusions

In properly selected patients, liver resections at the time of cytoreduction increase rates of optimal cytoreduction and improve survival in advanced-stage and recurrent ovarian cancer patients.

Keywords

Cytoreduction Debulking surgery Liver metastases Hepatectomy Ovarian cancer Recurrent ovarian cancer 

Notes

Funding

No funding source supported the present investigation.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. Abood G, Bowen M, Potkul R, Aranha G, Shoup M (2008) Hepatic resection for recurrent metastatic ovarian cancer. Am J Surg 195:370–373CrossRefPubMedGoogle Scholar
  2. Adam R, Aloia T, Krissat J, Bralet MP, Paule B, Giacchetti S, Delvart V, Azoulay D, Bismuth H, Castaing D (2006a) Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg 244:897–907CrossRefPubMedPubMedCentralGoogle Scholar
  3. Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G, Association Française de Chirurgie (2006b) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244:524–535CrossRefPubMedPubMedCentralGoogle Scholar
  4. Aletti GD, Podratz KC, Jones MB, Cliby WA (2006) Role of rectosigmoidectomy and stripping of pelvic peritoneum in outcomes of patients with advanced ovarian cancer—a preliminary report. J Am Coll Surg 203:521–526CrossRefPubMedGoogle Scholar
  5. Alseidi A, Helton WS, Espat NJ (2006) Does the literature support an indication for hepatic metastasectomy other than for colorectal primary? J Gastrointest Surg 10(1):99–104CrossRefPubMedGoogle Scholar
  6. Armstrong DK, Bundy B, Wenzel L et al (2006) Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354:34–43CrossRefPubMedGoogle Scholar
  7. Bleicher RJ, Allegra DP, Nora DT, Wood TF, Foshag LJ, Bilchik AJ (2003) Radiofrequency ablation in 447 complex unresectable liver tumors: lessons learned. Ann Surg Oncol 10:52–58CrossRefPubMedGoogle Scholar
  8. Bojalian MO, Machado GR, Swensen R, Reeves ME (2004) Radiofrequency ablation of liver metastasis from ovarian adenocarcinoma: case report and literature review. Gynecol Oncol 93(2):557–560CrossRefPubMedGoogle Scholar
  9. Bristow RE, Montz FJ, Lagasse LD, Leuchter RS, Karlan BY (1999) Survival impact of surgical cytoreduction in stage IV epithelial ovarian cancer. Gynecol Oncol 72(3):278–287CrossRefPubMedGoogle Scholar
  10. Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a metaanalysis. J Clin Oncol 20:1248–1259CrossRefPubMedGoogle Scholar
  11. Cannistra SA (2004) Cancer of the ovary. N Engl J Med 351:2519–2529CrossRefPubMedGoogle Scholar
  12. Chalkiadakis GE, Lasithiotakis KG, Petrakis I, Kourousis C, Georgoulias V (2005) Major hepatectomy and right hemicolectomy at the time of primary cytoreductive surgery for advanced ovarian cancer: report of a case. Int J Gynecol Cancer 15(6):1115–1119CrossRefPubMedGoogle Scholar
  13. Chi DS, McCaughty K, Diaz JP et al (2006) Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma. Cancer 106:1933–1939CrossRefPubMedGoogle Scholar
  14. Chi DS, Eisenhauer EL, Zivanovic O, Sonoda Y, Abu-Rustum NR, Levine DA, Guile MW, Bristow RE, Aghajanian C, Barakat RR (2009) Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 114:26–31CrossRefPubMedGoogle Scholar
  15. Du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 115:1234–1244CrossRefPubMedGoogle Scholar
  16. Eisenhauer EL, Abu-Rustum NR, Sonoda Y, Levine DA, Poynor EA, Aghajanian C, Jarnagin WR, DeMatteo RP, D’Angelica MI, Barakat RR, Chi DS (2006) The addition of extensive upper abdominal surgery to achieve optimal cytoreduction improves survival in patients with stages IIIC–IV epithelial ovarian cancer. Gynecol Oncol 103(3):1083–1090CrossRefPubMedGoogle Scholar
  17. Eisenkop SM, Spirtos NM, Lin WC (2006) Splenectomy in the context of primary cytoreductive operations for advanced epithelial cancer. Gynecol Oncol 100:344–348CrossRefPubMedGoogle Scholar
  18. Harter P, du Bois A, Hahmann M et al (2006) Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Ann Surg Oncol 13:1702–1710CrossRefPubMedGoogle Scholar
  19. Jacobs IA, Chang CK, Salti G (2003) Hepatic radiofrequency ablation of metastatic ovarian granulosa cell tumors. Am Surg 69(5):416–418PubMedGoogle Scholar
  20. Kanas GP, Taylor A, Primrose JN et al (2012) Survival after liver resection in metastatic colorectal cancer: review and metaanalysis of prognostic factors. Clin Epidemiol 4:283–301PubMedPubMedCentralGoogle Scholar
  21. Kehoe S, Hook J, Nankivell M et al (2015) Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 386:249–257CrossRefPubMedGoogle Scholar
  22. Kolev V, Pereira EB, Schwartz M, Sarpel U, Roayaie S, Labow D, Momeni M, Chuang L, Dottino P, Rahaman J, Zakashansky K (2014) The role of liver resection at the time of secondary cytoreduction in patients with recurrent ovarian cancer. Int J Gynecol Cancer 24(1):70–74CrossRefPubMedGoogle Scholar
  23. Learn PA, Bach PR (2010) A decade of mortality reductions in major oncologic surgery: the impact of centralization and quality improvement. Med Care 48:1041–1049CrossRefPubMedGoogle Scholar
  24. Lee YT (1984) Breast carcinoma: pattern of recurrence and metastasis after mastectomy. Am J Clin Oncol 7:443–449CrossRefPubMedGoogle Scholar
  25. Lim MC, Kang S, Lee KS, Han SS, Park SJ, Seo SS, Park SY (2009) The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer. Gynecol Oncol 112(1):28–34CrossRefPubMedGoogle Scholar
  26. Loizzi V, Rossi C, Cormio G, Cazzolla A, Altomare D, Selvaggi L (2005) Clinical features of hepatic metastasis in patients with ovarian cancer. Int J Gynecol Cancer 15(1):26–31CrossRefPubMedGoogle Scholar
  27. Magtibay PM, Adams PB, Silverman MB, Cha SS, Podratz KC (2006) Splenectomy as part of cytoreductive surgery in ovarian cancer. Gynecol Oncol 102:369–374CrossRefPubMedGoogle Scholar
  28. Mateo R, Singh G, Jabbour N, Palmer S, Genyk Y, Roman L (2005) Optimal cytoreduction after combined resection and radiofrequency ablation of hepatic metastases from recurrent malignant ovarian tumors. Gynecol Oncol 97(1):266–270CrossRefPubMedGoogle Scholar
  29. Meredith MA, Cliby WA, Keeney GL, Lesnick TG, Nagorney DM, Podratz KC (2003) Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol 89:16–21CrossRefGoogle Scholar
  30. Nathan H, Cameron JL, Choti MA et al (2009) The volume-outcomes effect in hepato-pancreato-biliary surgery: hospital versus surgeon contribution and specificity of the relationship. J Am Coll Surg 208:528–538CrossRefPubMedGoogle Scholar
  31. Neumann UP, Fotopoulou C, Schmeding M, Thelen A, Papanikolaou G, Braicu EI, Neuhaus P, Sehouli J (2012) Clinical outcome of patients with advanced ovarian cancer after resection of liver metastases. Anticancer Res 32(10):4517–4521PubMedGoogle Scholar
  32. Niu G, Shen C, Cui W, Li Q (2012) Hepatic resection is safe for metachronous hepatic metastases from ovarian cancer. Cancer Biol Med 9:182–187PubMedPubMedCentralGoogle Scholar
  33. Papadia A, Morotti M (2013) Diaphragmatic surgery during cytoreduction for primary or recurrent epithelial ovarian cancer: a review of the literature. Arch Gynecol Obstet 287:733–741CrossRefPubMedGoogle Scholar
  34. Papadia A, Moya Y, Rodgers SE et al (2011) Surgical resection of recurrent upper abdominal cervical cancer: a case report and review of the literature. Gynecol Oncol Case Rep 1:8–9CrossRefPubMedPubMedCentralGoogle Scholar
  35. Pekmezci S, Saribeyoglu K, Aytac E, Arvas M, Demirkiran F, Ozguroglu M (2010) Surgery for isolated liver metastasis of ovarian cancer. Asian J Surg 30(2):83–88CrossRefGoogle Scholar
  36. Peterhans M, vom Berg A A, Dagon B et al (2011) A navigation system for open liver surgery: design, workflow and first clinical applications. Int J Med Robot 7:7–16CrossRefPubMedGoogle Scholar
  37. Prat J (2015) FIGO Committee on Gynecologic Oncology. Abridged republication of FIGO’s staging classification for cancer of the ovary, fallopian tube, and peritoneum. Cancer. doi: 10.1002/cncr.29524
  38. Roh HJ, Kim DY, Joo WD, Yoo HJ, Kim JH, Kim YM, Kim YT, Nam JH (2011) Hepatic resection as part of secondary cytoreductive surgery for recurrent ovarian cancer involving the liver. Arch Gynecol Obstet 284(5):1223–1229CrossRefPubMedGoogle Scholar
  39. Rose PG, Piver MS, Tsukada Y, Lau TS (1989) Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. Cancer 64:1508–1513CrossRefPubMedGoogle Scholar
  40. Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29CrossRefPubMedGoogle Scholar
  41. Tangjitgamol S, Levenback CF, Beller U, Kavanagh JJ (2004) Role of surgical resection for lung, liver, and central nervous system metastases in patients with gynecological cancer: a literature review. Int J Gynecol Cancer 14(3):399–422CrossRefPubMedGoogle Scholar
  42. Veereman G, Robays J, Verleye L et al (2015) Pooled analysis of the surgical treatment for colorectal cancer liver metastases. Crit Rev Oncol/Hematol 94:122–135CrossRefGoogle Scholar
  43. Vergote I, Tropé CG, Amant FA et al (2010) Neoadjuvant chemotherapy or primary surgery in stage IIIc–IV ovarian cancer. N Engl J Med 363:943–953CrossRefPubMedGoogle Scholar
  44. Weitz J, Blumgart LH, Fong Y, Jarnagin WR, D’Angelica M, Harrison LE et al (2005) Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann Surg 241:269–276CrossRefPubMedPubMedCentralGoogle Scholar
  45. Winter WE III, Maxwell GL, Tian C, Sundborg MJ, Rose GS, Rose PG et al (2008) Tumor residual after surgical cytoreduction in prediction of clinical outcome in stage IV epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 26:83–89CrossRefPubMedGoogle Scholar
  46. Yoon SS, Jarnagin WR, Fong Y, DeMatteo RP, Barakat RR, Blumgart LH, Chi DS (2003) Resection of recurrent ovarian or fallopian tube carcinoma involving the liver. Gynecol Oncol 91(2):383–388CrossRefPubMedGoogle Scholar
  47. Zang RY, Harter P, Chi DS et al (2011) Predictors of survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery based on the pooled analysis of an international collaborative cohort. Br J Cancer 105:890–896CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Maria Luisa Gasparri
    • 1
    • 3
  • Giovanni Grandi
    • 2
  • Daniele Bolla
    • 3
  • Beat Gloor
    • 4
  • Sara Imboden
    • 3
  • Pierluigi Benedetti Panici
    • 1
  • Michael D. Mueller
    • 3
  • Andrea Papadia
    • 3
    Email author
  1. 1.Department of Obstetrics and Gynecology“Sapienza” University of RomeRomeItaly
  2. 2.Department of Obstetrics and GynecologyUniversity of ModenaModenaItaly
  3. 3.Department of Obstetrics and Gynecology, InselspitalBerne UniversityBerneSwitzerland
  4. 4.Department of Surgery, InselspitalBerne UniversityBerneSwitzerland

Personalised recommendations