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논문 기본 정보

자료유형
학술저널
저자정보
Shinichi Tate (Chiba University School of Medicine) Kyoko Nishikimi (Chiba University School of Medicine) Kazuyoshi Kato (Tokyo Medical University) Ayumu Matsuoka (Chiba University Graduate School of Medicine) Michiyo Kambe (Nasional Hospital Organization Chiba Medical Center) Takako Kiyokawa (The Jikei University School of Medicine) Makio Shozu (Chiba University School of Medicine)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.31 No.3
발행연도
2020.1
수록면
1 - 16 (16page)

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Objective: This study aimed to evaluate the presence of pathological residual tumor (pRT) in each initial disseminated site after neoadjuvant chemotherapy (NACT) to assess the appropriate surgical margins during interval debulking surgery (IDS) for a favorable prognosis. Methods: This prospective descriptive study included patients with stage IIIC–IV epithelial ovarian, fallopian tubal, and peritoneal cancer. One hundred eleven patients underwent diagnostic exploratory laparotomy, and their initial intra-abdominal dissemination statuses were recorded. Any tumor >1 cm in diameter found during the exploratory laparotomy was resected during IDS even if it was macroscopically invisible after NACT. The pRT rate after NACT and negative predictive value (NPV; probability that sites with macroscopically invisible tumors have no pRT) during IDS were assessed in each disseminated site. Results: A median of 5 NACT cycles were performed. Sites with a high incidence of pRT and low NPV included the rectosigmoid colon (71.4%, 38.6%), transverse mesentery (70.3%, 50.0%), greater omentum (68.3%, 51.7%), right diaphragm (61.9%, 48.1%), paracolic gutters (61.1%, 50.0%), and vesicouterine pouch (56.6%, 50.0%). Organs/tissues with a high incidence of pRT featured a low NPV. The median progression-free survival and overall survival in this cohort were 27.7 and 71.9 months, respectively. Conclusion: Even if a disseminated site >1 cm in diameter before NACT is invisible during IDS, microscopic disease remains present within it. The appropriate surgical margins for IDS with a favorable prognosis could be secured by resecting a lesion of >1 cm before NACT even if it is invisible during IDS.
#Residual Disease #Minimal #Debulking Surgical Procedures #Surgical Margins #Ovarian Cancer

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참고문헌 (34)

참고문헌 신청
Chi DS / 2006 / What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma(EOC)? / Gynecol Oncol 103:559~564 google schola Wimberger P / 2007 / Prognostic factors for complete debulking in advanced ovarian cancer and its impact on survival. An exploratory analysis of a prospectively randomized phase III study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group(AGO-OVAR) / Gynecol Oncol 106:69~74 google schola Chang SJ / 2012 / Impact of complete cytoreduction leaving no gross residual disease associated with radical cytoreductive surgical procedures on survival in advanced ovarian cancer / Ann Surg Oncol 19:4059~4067 google schola du Bois A / 2009 / Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer : a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials : by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom(AGO-OVAR)and the Groupe d'Investigateurs Nationaux Pour les Etudes des Cancers de l'Ovaire(GINECO) / Cancer 115:1234~1244 google schola Fagotti A / 2016 / Phase III randomised clinical trial comparing primary surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer with high tumour load(SCORPION trial) : Final analysis of peri-operative outcome / Eur J Cancer 59:22~33 google schola

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