Influence of Intraperitoneal Dissemination Assessed by Laparoscopy on Prognosis of Advanced Ovarian Cancer: An Exploratory Analysis of a Single-Institution Experience

Vito Chiantera, Marco Petrillo, Giuseppe Vizzielli, Barbara Costantini, Lucia Tortorella, Raffaella Iodice, Raffaella Iodice, Giovanni Scambia, Vito Chiantera, Alfredo Ercoli, Francesco Fanfani, Anna Fagotti, Giovanni Scambia

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36 Citations (Scopus)

Abstract

Purpose: The aim of this study was to investigate whether preoperative laparoscopic evaluation of the dissemination of disease may have an independent impact on survival in advanced epithelial ovarian cancer (AEOC).Methods: All AEOC women were submitted to staging laparoscopy before receiving primary debulking surgery (PDS) or neoadjuvant chemotherapy (NACT). All study women received a laparoscopic score (predictive index value [PIV]) and were stratified into three groups based on volume of disease: high tumor load (HTL) for PIV ≥8, intermediate tumor load (ITL) for PIV equal to 6 and 4, and low tumor load (LTL) for PIV <4. Surgical and survival outcome were evaluated by univariate and multivariate analysis.Results: Among 348 consecutive patients, almost half (48.0 %) had an HTL. Among 165 cases receiving PDS, residual tumor (RT) was as follows: no gross residual in 102 patients (61.8 %); RT ≤1 cm in 48 patients (29.1 %) and RT >1 cm in 15 cases (9.1 %). When stratifying the whole population according to laparoscopic tumor load, the median progression-free survival (PFS) was 33 months for LTL, 18 months for ITL, and 14 months for HTL (p = 0.0001). The median overall survival (OS) with respect to laparoscopic PIV was not reached for LTL, whereas it was 47 months for ITL and 33 months for HTL, respectively (p = 0.0001). At multivariate analysis, tumor load stratified by PIV retained an independent prognostic value on PFS and OS, together with RT and performance status.Conclusions: RT remains an important prognostic factor in patients with AEOC, but tumor dissemination can play a role in determining prognosis in these women.
Original languageEnglish
Pages (from-to)3970-3977
Number of pages8
JournalAnnals of Surgical Oncology
Volume21
Publication statusPublished - 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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