Gynecological Oncology Department, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Etlik Street, Ankara, 06010, Turkey.
Arch Gynecol Obstet. 2021 Jan;303(1):241-248. doi: 10.1007/s00404-020-05802-0. Epub 2020 Sep 28.
Demonstrate survival outcomes of stage 3B/3C ovarian-tubal-peritoneal epithelial cancer patients who had metastases on diaphragm.
141 patients who had undergone diaphragm surgery as a part of primary cytoreductive surgery procedures performed for stage 3B and 3C ovarian-tubal-peritoneal epithelial cancers were reviewed retrospectively. Patients who were administered neoadjuvant chemotherapy and patients who were suboptimally cytoreduced were not included to the study.
Median follow-up time was 42 months. Median overall survival of the patients who underwent diaphragm full-thickness resection (n = 18) because of tumors infiltrating diaphragm muscle was 40 months. Median overall survival of the patients who did not have a transdiaphragmatic thoracotomy (n = 113) was 77 months. Patients who underwent a willful full-thickness diaphragm resection because of tumors invading diaphragm muscle had significantly shorter survival compared with patients who did not have a transdiaphragmatic thoracotomy (p = 0.033). Seven (38.9%) of the 18 patients who underwent diaphragm full-thickness resection developed a recurrence in thorax. Twelve (9.8%) of the remaining 123 patients developed a recurrence in thorax. Patients who underwent full-thickness diaphragm resection because of tumors infiltrating diaphragm muscle developed recurrence in the thorax more frequently (p = 0.001).
Diaphragm muscle involvement is a predictor of thorax recurrences and worse survival outcomes in stage 3B and 3C ovarian-tubal-peritoneal epithelial cancers. Thus, this should be considered when selecting appropriate adjuvant treatment and route of administration (intravenous/intraperitoneal) in patients who had diaphragm implants infiltrating diaphragm muscle.
展示有膈肌转移的 3B/3C 期卵巢-输卵管-腹膜上皮性癌患者的生存结果。
回顾性分析了 141 例因 3B 和 3C 期卵巢-输卵管-腹膜上皮性癌而行原发性细胞减灭术并同时行膈肌切除术的患者。未接受新辅助化疗和未行满意细胞减灭术的患者未纳入本研究。
中位随访时间为 42 个月。因肿瘤浸润膈肌肌层而行膈肌全层切除术（n=18）的患者的中位总生存期为 40 个月。未行膈肌开胸术（n=113）的患者的中位总生存期为 77 个月。因肿瘤侵犯膈肌而行有意愿的膈肌全层切除术的患者与未行膈肌开胸术的患者相比，生存时间明显缩短（p=0.033）。18 例行膈肌全层切除术的患者中有 7 例（38.9%）在胸部复发。其余 123 例患者中有 12 例（9.8%）在胸部复发。因肿瘤浸润膈肌而行膈肌全层切除术的患者更频繁地发生胸部复发（p=0.001）。
膈肌受累是 3B 和 3C 期卵巢-输卵管-腹膜上皮性癌患者出现胸部复发和生存结果较差的预测因素。因此，在选择有膈肌种植浸润的患者的辅助治疗和给药途径（静脉/腹腔）时，应考虑这一点。
