Diaphragmatic surgery during primary cytoreduction for advanced ovarian cancer: Peritoneal stripping versus diaphragmatic resection

Ignacio Zapardiel, Michele Peiretti, Vanna Zanagnolo, Roberto Biffi, Luca Bocciolone, Fabio Landoni, Giovanni Aletti, Nicoletta Colombo, Angelo Maggioni

Research output: Contribution to journalArticle

Abstract

Background: Standard approach for medically stable advanced ovarian cancer patients should be primary cytoreduction following platinum-based chemotherapy. The aim of surgical effort should be the complete removal of all visible disease. Our objective was to compare perioperative features, postoperative complications, and secondarily oncological outcomes of patients who underwent diaphragmatic stripping with those who underwent diaphragmatic resection for advanced ovarian cancer. Methods: One hundred twelve cases were identified, among them 79 underwent diaphragmatic stripping and 33 underwent diaphragmatic full-thickness resection. Data collected included patients' age, all perioperative details and pathological findings, International Federation of Gynecology and Obstetrics stage, adjuvant therapy, and follow-up data. Results: Larger residual tumors (mean, 5.1 vs 1.6 mm, respectively; P <0.01) but shorter operating time (25 minutes shorter operative time, P = 0.07) were observed in the stripping group. Higher postoperative pleural effusions rates (63.6% vs 37.9%, P = 0.01), but no differences in the remaining complications, were observed in the resection group. After a mean of 31 months of follow-up, disease-free survival rates were 27.8% in the stripping group and 39.4% in the resection group (P = 0.04). No significant differences were observed for overall survival. Conclusions: Diaphragmatic surgery at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to the achievement of complete cytoreduction with low perioperative complication rate; full-thickness resection is preferable if peritoneum stripping will not achieve a complete removal of the disease.

Original languageEnglish
Pages (from-to)1698-1703
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume21
Issue number9
DOIs
Publication statusPublished - Dec 2011

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Ovarian Neoplasms
Peritoneum
Residual Neoplasm
Pleural Effusion
Operative Time
Platinum
Gynecology
Obstetrics
Disease-Free Survival
Survival Rate
Drug Therapy
Survival
Therapeutics

Keywords

  • Diaphragmatic resection
  • Diaphragmatic stripping
  • Diaphragmatic surgery
  • Ovarian cancer
  • Primary cytoreduction

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

Cite this

@article{45e1e24dcef34ea597d8e886a83c4d26,
title = "Diaphragmatic surgery during primary cytoreduction for advanced ovarian cancer: Peritoneal stripping versus diaphragmatic resection",
abstract = "Background: Standard approach for medically stable advanced ovarian cancer patients should be primary cytoreduction following platinum-based chemotherapy. The aim of surgical effort should be the complete removal of all visible disease. Our objective was to compare perioperative features, postoperative complications, and secondarily oncological outcomes of patients who underwent diaphragmatic stripping with those who underwent diaphragmatic resection for advanced ovarian cancer. Methods: One hundred twelve cases were identified, among them 79 underwent diaphragmatic stripping and 33 underwent diaphragmatic full-thickness resection. Data collected included patients' age, all perioperative details and pathological findings, International Federation of Gynecology and Obstetrics stage, adjuvant therapy, and follow-up data. Results: Larger residual tumors (mean, 5.1 vs 1.6 mm, respectively; P <0.01) but shorter operating time (25 minutes shorter operative time, P = 0.07) were observed in the stripping group. Higher postoperative pleural effusions rates (63.6{\%} vs 37.9{\%}, P = 0.01), but no differences in the remaining complications, were observed in the resection group. After a mean of 31 months of follow-up, disease-free survival rates were 27.8{\%} in the stripping group and 39.4{\%} in the resection group (P = 0.04). No significant differences were observed for overall survival. Conclusions: Diaphragmatic surgery at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to the achievement of complete cytoreduction with low perioperative complication rate; full-thickness resection is preferable if peritoneum stripping will not achieve a complete removal of the disease.",
keywords = "Diaphragmatic resection, Diaphragmatic stripping, Diaphragmatic surgery, Ovarian cancer, Primary cytoreduction",
author = "Ignacio Zapardiel and Michele Peiretti and Vanna Zanagnolo and Roberto Biffi and Luca Bocciolone and Fabio Landoni and Giovanni Aletti and Nicoletta Colombo and Angelo Maggioni",
year = "2011",
month = "12",
doi = "10.1097/IGC.0b013e31822f65c3",
language = "English",
volume = "21",
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journal = "International Journal of Gynecological Cancer",
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TY - JOUR

T1 - Diaphragmatic surgery during primary cytoreduction for advanced ovarian cancer

T2 - Peritoneal stripping versus diaphragmatic resection

AU - Zapardiel, Ignacio

AU - Peiretti, Michele

AU - Zanagnolo, Vanna

AU - Biffi, Roberto

AU - Bocciolone, Luca

AU - Landoni, Fabio

AU - Aletti, Giovanni

AU - Colombo, Nicoletta

AU - Maggioni, Angelo

PY - 2011/12

Y1 - 2011/12

N2 - Background: Standard approach for medically stable advanced ovarian cancer patients should be primary cytoreduction following platinum-based chemotherapy. The aim of surgical effort should be the complete removal of all visible disease. Our objective was to compare perioperative features, postoperative complications, and secondarily oncological outcomes of patients who underwent diaphragmatic stripping with those who underwent diaphragmatic resection for advanced ovarian cancer. Methods: One hundred twelve cases were identified, among them 79 underwent diaphragmatic stripping and 33 underwent diaphragmatic full-thickness resection. Data collected included patients' age, all perioperative details and pathological findings, International Federation of Gynecology and Obstetrics stage, adjuvant therapy, and follow-up data. Results: Larger residual tumors (mean, 5.1 vs 1.6 mm, respectively; P <0.01) but shorter operating time (25 minutes shorter operative time, P = 0.07) were observed in the stripping group. Higher postoperative pleural effusions rates (63.6% vs 37.9%, P = 0.01), but no differences in the remaining complications, were observed in the resection group. After a mean of 31 months of follow-up, disease-free survival rates were 27.8% in the stripping group and 39.4% in the resection group (P = 0.04). No significant differences were observed for overall survival. Conclusions: Diaphragmatic surgery at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to the achievement of complete cytoreduction with low perioperative complication rate; full-thickness resection is preferable if peritoneum stripping will not achieve a complete removal of the disease.

AB - Background: Standard approach for medically stable advanced ovarian cancer patients should be primary cytoreduction following platinum-based chemotherapy. The aim of surgical effort should be the complete removal of all visible disease. Our objective was to compare perioperative features, postoperative complications, and secondarily oncological outcomes of patients who underwent diaphragmatic stripping with those who underwent diaphragmatic resection for advanced ovarian cancer. Methods: One hundred twelve cases were identified, among them 79 underwent diaphragmatic stripping and 33 underwent diaphragmatic full-thickness resection. Data collected included patients' age, all perioperative details and pathological findings, International Federation of Gynecology and Obstetrics stage, adjuvant therapy, and follow-up data. Results: Larger residual tumors (mean, 5.1 vs 1.6 mm, respectively; P <0.01) but shorter operating time (25 minutes shorter operative time, P = 0.07) were observed in the stripping group. Higher postoperative pleural effusions rates (63.6% vs 37.9%, P = 0.01), but no differences in the remaining complications, were observed in the resection group. After a mean of 31 months of follow-up, disease-free survival rates were 27.8% in the stripping group and 39.4% in the resection group (P = 0.04). No significant differences were observed for overall survival. Conclusions: Diaphragmatic surgery at the time of primary cytoreductive surgery for advanced ovarian cancer may contribute to the achievement of complete cytoreduction with low perioperative complication rate; full-thickness resection is preferable if peritoneum stripping will not achieve a complete removal of the disease.

KW - Diaphragmatic resection

KW - Diaphragmatic stripping

KW - Diaphragmatic surgery

KW - Ovarian cancer

KW - Primary cytoreduction

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