Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France.
Eur J Surg Oncol. 2019 Sep;45(9):1619-1624. doi: 10.1016/j.ejso.2019.04.011. Epub 2019 Apr 17.
Complete removal of disease is the most important prognostic factor for patients with advanced epithelial ovarian carcinoma. However, the influence of carcinomatosis distribution on prognosis is unknown and the prognostic impact of implant size according to their location is poorly studied. Our objective was to assess the impact of peritoneal carcinomatosis quantitative and qualitative localizations on progression free survival (PFS) in patients with advanced epithelial ovarian carcinoma (AEOC) after complete cytoreductive surgery.
We conducted a monocentric cohort study, retrospective from October 2001 to July 2014. Inclusion criteria were high-grade AEOC patients without residual disease (CC0) after primary debulking surgery (PDS) or after interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Peritoneal carcinomatosis was assessed according to qualitative criteria and quantitative criteria.
One hundred and one patients were included. Median PFS was 21·2 months and median OS was 62·2 months. On the whole population, involvement of adipocytes-enriched areas tended to be associated with a decreased PFS and was significantly associated with a decreased OS. Any localization was associated with PFS or OS in the "IDS" subgroup. In the "PDS" subgroup, PCI score and involvement of the right mesocolic area were associated with a decreased PFS.
Initial tumor load has not been found associated with PFS after complete surgery. Adipocytes-enriched areas and right mesocolic areas involvement were associated with poor prognosis in patients receiving primary debulking surgery. Larger-scale studies are needed to assess whether initial tumor load has a prognostic impact even after complete cytoreductive surgery is achieved.
完全清除疾病是晚期上皮性卵巢癌患者最重要的预后因素。然而，癌转移分布对预后的影响尚不清楚，根据其位置大小对预后的影响也研究甚少。我们的目的是评估完全细胞减灭术后晚期上皮性卵巢癌（AEOC）患者腹膜癌病定量和定性定位对无进展生存期（PFS）的影响。
我们进行了一项单中心队列研究，回顾性分析 2001 年 10 月至 2014 年 7 月的患者资料。纳入标准为高分级 AEOC 患者，在初次肿瘤细胞减灭术（PDS）或新辅助化疗（NACT）后间隔肿瘤细胞减灭术（IDS）后无残余疾病（CC0）。腹膜癌病的评估依据定性和定量标准。
共纳入 101 例患者。中位 PFS 为 21.2 个月，中位 OS 为 62.2 个月。在全人群中，富含脂肪细胞区域的累及与 PFS 降低有关，与 OS 降低显著相关。任何部位的累及与“IDS”亚组的 PFS 或 OS 相关。在“PDS”亚组中，PCI 评分和右结肠系膜区域累及与 PFS 降低有关。
在完全手术后，初始肿瘤负荷与 PFS 无关。富含脂肪细胞的区域和右结肠系膜区域的累及与接受初次肿瘤细胞减灭术患者的不良预后相关。需要更大规模的研究来评估即使在完全细胞减灭术后，初始肿瘤负荷是否具有预后影响。
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