Negative peritoneal washing cytology during interval debulking surgery predicts overall survival after neoadjuvant chemotherapy for ovarian cancer

Ayaka Iura; Morihito Takita; Aiko Kawano; Kazuaki IMAI; Katsuyuki Konnai; Ryo Onose; Hisamori Kato

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자료유형: 학술저널

저자정보: Ayaka Iura (Kanagawa Cancer Center Kanagawa Japan.) Morihito Takita (Kanagawa Cancer Center Kanagawa Japan.) Aiko Kawano (Kanagawa Cancer Center Kanagawa Japan.) Kazuaki IMAI (Kanagawa Cancer Center Kanagawa Japan.) Katsuyuki Konnai (Kanagawa Cancer Center Kanagawa Japan.) Ryo Onose (Kanagawa Cancer Center Kanagawa Japan.) Hisamori Kato (Kanagawa Cancer Center Kanagawa Japan.)

저널정보: 대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.29 No.5

발행연도: 2018.1

수록면: 1 - 11 (11page)

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연구주제

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연구배경

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연구방법

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Objective: Optimal debulking in interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) has been reported as a prognostic factor for patients with ovarian cancer. However, the identification of microscopic residual disease (MRD) using visualization and palpation is subjective. Peritoneal washing cytology (PWC) during IDS is an easy-to-implement, objective approach for assessing disease status, although its clinical relevance and association with MRD is not known. The aim of this study was to evaluate the efficacy of PWC during IDS. Methods: In total, 164 patients diagnosed with ovarian cancer at our institution were retrospectively evaluated, including 64 who had received NAC. Seventeen patients had undergone an exploratory laparotomy followed by NAC, while the remaining patients were diagnosed based on imaging, peritoneal cytology, and tumor markers. The PWC was performed before intraperitoneal observation at laparotomy during IDS. Results: NAC-treated patients had stage III–IV disease. IDS was performed in 78.1% of NAC-treated patients. Seventeen patients (26.6%) were PWC-negative and 33 patients (51.6%) were PWC-positive. Fourteen patients (21.9%) had progressive disease and were ineligible for IDS. The median overall survival of the PWC-negative, PWC-positive, and non-IDS groups was 47, 18, and 5 months, respectively. The differences were significant (p<0.01). PWC was an independent prognostic factor in the multivariate Cox regression analysis (p<0.001). Conclusion: PWC during IDS may be a prognostic factor for NAC-treated patients with ovarian cancer. PWC may be more useful than visualization and palpation in IDS for determining the presence of MRD.

참고문헌 (17)

참고문헌 신청

Onda T / 2011 / Neoadjuvant chemotherapy for advanced ovarian cancer: overview of outcomes and unanswered questions / Expert Rev Anticancer Ther 11:1053~1067

Kuhn W / 2001 / Neoadjuvant chemotherapy followed by tumor debulking prolongs survival for patients with poor prognosis in International Federation of Gynecology and Obstetrics Stage IIIC ovarian carcinoma / Cancer 92:2585~2591

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