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The Potential Prognostic Impact of Associated Peritoneal Carcinomatosis in Patients with Stage II and III Epithelial Ovarian Cancer Who Had Upfront Complete Cytoreduction

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Abstract

Background

The presence of metastatic peritoneal nodules in epithelial ovarian cancer (EOC) is considered a prognostic factor of both overall survival and disease-free survival. The goal of this study is to assess the potential prognostic effect of associated peritoneal carcinomatosis and PCI in stage II and III EOC patients after undergoing complete cytoreduction (CC score 0 or 1).

Patients and Methods

This is a retrospective cohort study including 50 high-grade serous EOC cases treated and followed up from 2012 and 2016. Twenty-three cases had peritoneal nodules at the time of exploration. PCI was assessed intraoperatively in each case. Twenty-seven cases had no peritoneal nodules (were given PCI 0).

Results

The presence of peritoneal nodules, presence of ascites, and stage of the disease had statistically significant impact on overall survival, but with multivariate analysis, only presence of peritoneal nodules was associated with a statistically significant reduced overall survival (HR 6.192; 95% CI 1.248–30.720; P value 0.026). The presence of peritoneal nodules was associated with a statistically significant higher incidence of postoperative death (P value 0.038). PCI had no statistically significant impact on overall survival, disease-free survival, or incidence of postoperative death (within 30 days after surgery).

Conclusion

The presence of peritoneal nodules had a statistically significant impact on overall survival and incidence of postoperative death. There was no statistically significant prognostic impact of PCI in stage II and III EOC patients who had complete cytoreduction.

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References

  1. Friedlander ML. Prognostic factors in ovarian cancer. Semin Oncol. 1998;25(3):305–14.

    CAS  PubMed  Google Scholar 

  2. Tentes AA, Tripsiannis G, Markakidis SK, Karanikiotis CN, Tzegas G, Georgiadis G, Avgidou K. Peritoneal cancer index: a prognostic indicator of survival in advanced ovarian cancer. Eur J Surg Oncol. 2003;29(1):69–73. https://doi.org/10.1053/ejso.2002.1380.

    Article  PubMed  Google Scholar 

  3. Cavaliere F, Giannarelli D, Valle M, Federici O, Liotta G, Perri P, Di Filippo F, Garofalo A, Ialongo P. Peritoneal carcinomatosis from ovarian epithelial primary: combined aggressive treatment. In Vivo. 2009;23(3):441–6.

    CAS  PubMed  Google Scholar 

  4. Uzan J, Bonsang-Kitzis H, Rossi L, Rance B, Bats AS, Gosset M, Deloménie M, Pujade-Lauraine E, Lécuru F, Ngô C. Prognostic impact of initial tumor load and intraperitoneal disease dissemination patterns in patients with advanced ovarian cancer undergoing complete cytoreductive surgery. Eur J Surg Oncol. 2019;45(9):1619–24. https://doi.org/10.1016/j.ejso.2019.04.011.

    Article  PubMed  Google Scholar 

  5. Sun JH, Ji ZH, Yu Y, Wu HT, Huang CQ, Zhang Q, Yang XJ, Yonemura Y, Li Y. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy to treat advanced/recurrent epithelial ovarian cancer: results from a retrospective study on prospectively established database. Transl Oncol. 2016;9(2):130–8. https://doi.org/10.1016/j.tranon.2016.02.002.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gasimli K, Braicu EI, Richter R, Chekerov R, Sehouli J. Prognostic and predictive value of the peritoneal cancer index in primary advanced epithelial ovarian cancer patients after complete cytoreductive surgery: study of tumor bank ovarian cancer. Ann Surg Oncol. 2015;22(8):2729–37. https://doi.org/10.1245/s10434-014-4329-7.

    Article  PubMed  Google Scholar 

  7. Elzarkaa AA, Shaalan W, Elemam D, Mansour H, Melis M, Malik E, Soliman AA. Peritoneal cancer index as a predictor of survival in advanced stage serous epithelial ovarian cancer: a prospective study. J Gynecol Oncol. 2018;29(4): e47. https://doi.org/10.3802/jgo.2018.29.e47.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Muñoz-Casares FC, Medina-Fernández FJ, Arjona-Sánchez Á, Casado-Adam Á, Sánchez-Hidalgo JM, Rubio MJ, Ortega-Salas R, Muñoz-Villanueva MC, Rufián-Peña S, Briceño FJ. Peritonectomy procedures and HIPEC in the treatment of peritoneal carcinomatosis from ovarian cancer: Long-term outcomes and perspectives from a high-volume center. Eur J Surg Oncol. 2016;42(2):224–33. https://doi.org/10.1016/j.ejso.2015.11.006.

    Article  PubMed  Google Scholar 

  9. Bakrin N, Cotte E, Golfier F, Gilly FN, Freyer G, Helm W, Glehen O, Bereder JM. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for persistent and recurrent advanced ovarian carcinoma: a multicenter, prospective study of 246 patients. Ann Surg Oncol. 2012;19(13):4052–8. https://doi.org/10.1245/s10434-012-2510-4.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgment

National Cancer Institute—Cairo University supported this study. National Cancer Institute did not play a role in the study design, data collection, data analysis, or manuscript writing. All the authors read and authorized the final manuscript.

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Authors and Affiliations

  1. Surgical Oncology Department, National Cancer Institute-Cairo University, 1 Kasr El-Aini Street, Foum El-Khalig, 11796, Egypt

    Mohamed Ibrahim Fahim

  2. Biostatistics and Cancer Epidemiology Department, National Cancer Institute-Cairo University, Foum El-Khalig, Egypt

    Rasha Mahmoud Allam

Authors
  1. Mohamed Ibrahim Fahim
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  2. Rasha Mahmoud Allam
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Contributions

All authors have contributed to this work. MIF has collected the data and written the manuscript. RMA has done the statistical analysis.

Corresponding author

Correspondence to Mohamed Ibrahim Fahim.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the institutional review board of the National Cancer Institute—Cairo University.

Informed Consent

All the patients included in the study signed informed consents.

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Mohamed Ibrahim Fahim is a Lecturer. Dr. Rasha Mahmoud Allam is a lecturer.

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Fahim, M.I., Allam, R.M. The Potential Prognostic Impact of Associated Peritoneal Carcinomatosis in Patients with Stage II and III Epithelial Ovarian Cancer Who Had Upfront Complete Cytoreduction. J Obstet Gynecol India (2024). https://doi.org/10.1007/s13224-024-01965-x

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  • DOI: https://doi.org/10.1007/s13224-024-01965-x

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