Abstract
Objective: Upper abdominal spread of primary and recurrent ovarian cancer is often considered to be a major obstacle to achieve optimal residual disease at the end of surgery. In this study, we investigate the role of diaphragmatic debulking in the natural history of advanced and recurrent epithelial ovarian cancer patients, and the morbidity of this procedure according to clinico-surgical characteristics. Methods: Data from 234 consecutive patients with primary and recurrent advanced ovarian cancer, operated at Catholic University of Rome and Campobasso from January 1, 2005 and December 31, 2008, were retrospectively reviewed. Results: Eighty-seven patients (37.2%) underwent a diaphragmatic surgery. Median age was 55 years (range 37-76). Diaphragmatic debulking was performed in 50 out of 120 patients at primary surgery (41.7%), in 16 out of 74 at interval debulking surgery (21.6%) and in 21 out of 40 secondary cytoreductions (52.5%). In the whole study population optimal residual disease at the end of surgery was achieved. The most frequent post-operative complication was pleural effusion, observed in 37 patients (42.5%). Presence of a post-operative pleural effusion was correlated liver mobilization (52.3% vs. 16%; p <0.0027) and large diaphragmatic disease (> 5 cm) removal (54.1% vs. 23.5%; p <0.034). Conclusions: Diaphragmatic surgery represents a crucial step in the debulking of advanced and recurrent ovarian cancer patients. Considering the natural history of advanced epithelial ovarian cancer and the rate of patients needing diaphragmatic debulking during primary cytoreduction, interval debulking surgery and secondary cytoreduction, this procedure should be present in the surgical repertoire of a gynecologic oncologist.
| Original language | English |
|---|---|
| Pages (from-to) | 497-501 |
| Number of pages | 5 |
| Journal | Gynecologic Oncology |
| Volume | 116 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2010 |
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Keywords
- Debulking
- Diaphragm
- Ovarian cancer
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Oncology
Cite this
Upper abdominal surgery in advanced and recurrent ovarian cancer : Role of diaphragmatic surgery. / Fanfani, Francesco; Fagotti, Anna; Gallotta, Valerio; Ercoli, Alfredo; Pacelli, Fabio; Costantini, Barbara; Vizzielli, Giuseppe; Margariti, Pasquale Alessandro; Garganese, Giorgia; Scambia, Giovanni.
In: Gynecologic Oncology, Vol. 116, No. 3, 03.2010, p. 497-501.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Upper abdominal surgery in advanced and recurrent ovarian cancer
T2 - Role of diaphragmatic surgery
AU - Fanfani, Francesco
AU - Fagotti, Anna
AU - Gallotta, Valerio
AU - Ercoli, Alfredo
AU - Pacelli, Fabio
AU - Costantini, Barbara
AU - Vizzielli, Giuseppe
AU - Margariti, Pasquale Alessandro
AU - Garganese, Giorgia
AU - Scambia, Giovanni
PY - 2010/3
Y1 - 2010/3
N2 - Objective: Upper abdominal spread of primary and recurrent ovarian cancer is often considered to be a major obstacle to achieve optimal residual disease at the end of surgery. In this study, we investigate the role of diaphragmatic debulking in the natural history of advanced and recurrent epithelial ovarian cancer patients, and the morbidity of this procedure according to clinico-surgical characteristics. Methods: Data from 234 consecutive patients with primary and recurrent advanced ovarian cancer, operated at Catholic University of Rome and Campobasso from January 1, 2005 and December 31, 2008, were retrospectively reviewed. Results: Eighty-seven patients (37.2%) underwent a diaphragmatic surgery. Median age was 55 years (range 37-76). Diaphragmatic debulking was performed in 50 out of 120 patients at primary surgery (41.7%), in 16 out of 74 at interval debulking surgery (21.6%) and in 21 out of 40 secondary cytoreductions (52.5%). In the whole study population optimal residual disease at the end of surgery was achieved. The most frequent post-operative complication was pleural effusion, observed in 37 patients (42.5%). Presence of a post-operative pleural effusion was correlated liver mobilization (52.3% vs. 16%; p <0.0027) and large diaphragmatic disease (> 5 cm) removal (54.1% vs. 23.5%; p <0.034). Conclusions: Diaphragmatic surgery represents a crucial step in the debulking of advanced and recurrent ovarian cancer patients. Considering the natural history of advanced epithelial ovarian cancer and the rate of patients needing diaphragmatic debulking during primary cytoreduction, interval debulking surgery and secondary cytoreduction, this procedure should be present in the surgical repertoire of a gynecologic oncologist.
AB - Objective: Upper abdominal spread of primary and recurrent ovarian cancer is often considered to be a major obstacle to achieve optimal residual disease at the end of surgery. In this study, we investigate the role of diaphragmatic debulking in the natural history of advanced and recurrent epithelial ovarian cancer patients, and the morbidity of this procedure according to clinico-surgical characteristics. Methods: Data from 234 consecutive patients with primary and recurrent advanced ovarian cancer, operated at Catholic University of Rome and Campobasso from January 1, 2005 and December 31, 2008, were retrospectively reviewed. Results: Eighty-seven patients (37.2%) underwent a diaphragmatic surgery. Median age was 55 years (range 37-76). Diaphragmatic debulking was performed in 50 out of 120 patients at primary surgery (41.7%), in 16 out of 74 at interval debulking surgery (21.6%) and in 21 out of 40 secondary cytoreductions (52.5%). In the whole study population optimal residual disease at the end of surgery was achieved. The most frequent post-operative complication was pleural effusion, observed in 37 patients (42.5%). Presence of a post-operative pleural effusion was correlated liver mobilization (52.3% vs. 16%; p <0.0027) and large diaphragmatic disease (> 5 cm) removal (54.1% vs. 23.5%; p <0.034). Conclusions: Diaphragmatic surgery represents a crucial step in the debulking of advanced and recurrent ovarian cancer patients. Considering the natural history of advanced epithelial ovarian cancer and the rate of patients needing diaphragmatic debulking during primary cytoreduction, interval debulking surgery and secondary cytoreduction, this procedure should be present in the surgical repertoire of a gynecologic oncologist.
KW - Debulking
KW - Diaphragm
KW - Ovarian cancer
UR - http://www.scopus.com/inward/record.url?scp=75749083239&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=75749083239&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2009.11.023
DO - 10.1016/j.ygyno.2009.11.023
M3 - Article
C2 - 20004958
AN - SCOPUS:75749083239
VL - 116
SP - 497
EP - 501
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -