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Omental Chemotherapy Effects as a Prognostic Factor in Ovarian Cancer Patients Treated With Neoadjuvant Chemotherapy and Delayed Primary Surgical Debulking

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

We sought to assess the prognostic significance of chemotherapy effect on upper abdominal metastatic disease.

Methods

Retrospective chart reviews were carried out from 1997 to 2005 to identify ovarian cancer patients treated with neoadjuvant chemotherapy. Pathologic examinations of resected omental and ovarian tumors for the presence of chemotherapy effect were performed. Cox proportional hazard models were built to model time to progression and death by using predictor variables of age, tumor grade, amount and location of largest residual disease, and the presence of chemotherapy effects on resected tumors.

Results

Sixty-six patients with available slides and clinical information were identified. The presence of omental chemotherapy effects was observed in 58 patients (88%). Identified independent statistically significant predictors for progression-free survival included presence of omental chemotherapy effect (hazard ratio [HR], .38; 95% confidence interval [95% CI], .17–.89; P = .026) and suboptimal tumor residuals in upper abdominal location compared with pelvic location (HR, 2.41; 95% CI, 1.06–5.48; P = .035). The presence of omental chemotherapy effect was the only statistically significant predictor of disease specific survival (HR, .21; 95% CI, .068–.639; P = .006). The estimated median survival for the group with positive omental chemotherapy effect was 84.45 months (95% CI, 69.63–99.28). The corresponding statistic in patients with no observed response to chemotherapy was 31.15 months (95% CI, 21.84–40.47).

Conclusions

Upper abdominal disease location and its response to chemotherapy were independent prognostic factors for progression-free survival. Aggressive upper abdominal debulking procedures are recommended to improve oncologic outcomes.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Ottawa General Hospital, University of Ottawa, 501 Smyth Road, Room 8130, K1H 8L6, Ottawa, Ontario, Canada

    Tien Le FRCSC, Laura Hopkins FRCSC & M. Fung-Kee-Fung FRCSC

  2. Department of Pathology and Laboratory medicine, University of Ottawa, Ottawa, Ontario, Canada

    Kona Williams MSc & Mary Senterman FRCPC

  3. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alberta, Edmonton, Alberta, Canada

    Wylam Faught FRCSC

Authors
  1. Tien Le FRCSC
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  2. Kona Williams MSc
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  3. Mary Senterman FRCPC
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  4. Laura Hopkins FRCSC
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  5. Wylam Faught FRCSC
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  6. M. Fung-Kee-Fung FRCSC
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Correspondence to Tien Le FRCSC.

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Le, T., Williams, K., Senterman, M. et al. Omental Chemotherapy Effects as a Prognostic Factor in Ovarian Cancer Patients Treated With Neoadjuvant Chemotherapy and Delayed Primary Surgical Debulking. Ann Surg Oncol 14, 2649–2653 (2007). https://doi.org/10.1245/s10434-007-9460-2

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  • DOI: https://doi.org/10.1245/s10434-007-9460-2

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