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Value of Diaphragmatic Surgery During Interval Debulking Surgery
Aurelie Pelissier1, Oona Franke2, Emile Darai3
1Department of Oncologic Surgery, Centre René Huguenin, Institut Curie, Saint Cloud, France a.komorek@gmail.com.
Anticancer Research
|December 27, 2017
Summary
Diaphragmatic surgery after neoadjuvant chemotherapy (NAC) for advanced ovarian cancer may offer limited value. Serum CA125 levels can help determine the need for diaphragmatic peritonectomy (DP) during interval debulking surgery (IDS).
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Chemotherapy
Background:
- Advanced ovarian cancer often requires neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS).
- The diaphragm is a common site for metastasis in advanced ovarian cancer.
- Assessing residual disease on the diaphragm after NAC can be challenging.
Purpose of the Study:
- To evaluate the effectiveness of diaphragmatic surgery for optimal debulking in advanced ovarian cancer patients receiving NAC.
- To determine if diaphragmatic peritonectomy (DP) during IDS improves outcomes.
- To explore the utility of serum CA125 levels in guiding the decision for DP.
Main Methods:
- Retrospective review of 182 advanced ovarian cancer patients treated with NAC.
- Comparison of outcomes between patients who underwent DP during IDS and those who did not.
- Analysis of serum CA125 levels, cytoreductive outcome, overall survival (OS), and relapse-free survival (RFS).
Main Results:
- CA125 normalization after NAC was significantly associated with a negative diaphragmatic peritonectomy (DP).
- Overall survival (OS) tended to be higher in patients without diaphragmatic disease (DP-negative group).
- Median OS was significantly longer for IDS without DP (40.7 months) compared to IDS with DP (22 months).
Conclusions:
- Evaluating residual diaphragmatic disease after NAC can be difficult.
- Serum CA125 levels may aid in selecting patients who would benefit from DP.
- Diaphragmatic surgery following NAC may have limited value in improving outcomes for advanced ovarian cancer.
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