DOCSLIB.ORG

Incidence and Predictors of Peritoneal Metastases of Gynecological Origin: a Population-Based Study in the Netherlands

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Incidence and Predictors of Peritoneal Metastases of Gynecological Origin: a Population-Based Study in the Netherlands J Gynecol Oncol. 2020 Sep;31(5):e58 https://doi.org/10.3802/jgo.2020.31.e58 pISSN 2005-0380·eISSN 2005-0399 Original Article Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands Lara Burg ,1 Maite Timmermans ,2,3,4 Maaike van der Aa ,2 Dorry Boll ,5 Koen Rovers ,6 Ignace de Hingh ,6 Anne van Altena 1 1Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands 2Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands Received: Dec 10, 2018 3Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands Revised: Mar 19, 2020 4GROW, School for Oncology and Developmental Biology, Maastricht, The Netherlands Accepted: Mar 22, 2020 5Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands 6Department of Surgical Oncology, Catharina Cancer Hospital, Eindhoven, The Netherlands Correspondence to Lara Burg Department of Obstetrics and Gynecology, Radboud University Medical Center, Geert ABSTRACT Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. Objective: Peritoneal metastases (PM) are a challenge in gynecological cancers, but its E-mail: [email protected] appearance has never been described in a population-based study. Therefore, we describe the Copyright © 2020. Asian Society of incidence of PM and identify predictors that increase the probability of peritoneal spread. Gynecologic Oncology, Korean Society of Methods: All ovarian, endometrial and cervical cancer patients diagnosed in the Netherlands Gynecologic Oncology, and Japan Society of between 1989 and 2015 were identified from the Netherlands Cancer Registry and stratified Gynecologic Oncology This is an Open Access article distributed for PM. Crude and age-adjusted incidence over time was calculated. Independent predictors under the terms of the Creative Commons for PM were identified using uni- and multivariable analyses. Attribution Non-Commercial License (https:// Results: The 94,981 patients were diagnosed with ovarian, endometrial or cervical creativecommons.org/licenses/by-nc/4.0/) cancer and respectively 61%, 2% and 1% presented with PM. Predictors for PM in ovarian which permits unrestricted non-commercial cancer were: age between 50 and 74 years (odds ratio [OR]=1.19; 95% confidence interval use, distribution, and reproduction in any [CI]=1.08–1.32), other distant metastases (OR=1.25; 95% CI=1.10–1.41), poor differentiation medium, provided the original work is properly cited. grade (OR=2.00; 95% CI=1.73–2.32) and serous histology. Predictors in endometrial cancer were lymph node metastases (OR=2.32; 95% CI=1.65–3.26), other distant metastases ORCID iDs (OR=1.38; 95% CI=1.08–1.77), high-grade tumors (OR=1.95; 95% CI=1.38–2.76) and clear Lara Burg cell (OR=1.49; 95% CI=1.04–2.13) or serous histology (OR=2.71; 95% CI=2.15–3.42). In https://orcid.org/0000-0003-4852-2118 Maite Timmermans cervical cancer, the risk is higher in adenocarcinoma than in squamous cell carcinoma https://orcid.org/0000-0002-9119-8328 (OR=4.92; 95% CI=3.11–7.79). Maaike van der Aa Conclusion: PM are frequently seen in patients with ovarian cancer. In endometrial and https://orcid.org/0000-0002-2934-2704 cervical cancer PM are rare. Histological subtype was the strongest predictive factor for PM Dorry Boll in all 3 cancers. Better understanding of predictive factors for PM and thus the biological https://orcid.org/0000-0002-5339-8505 behavior is of paramount importance. Koen Rovers https://orcid.org/0000-0001-8174-2134 Keywords: Peritoneal Neoplasms; Ovarian Neoplasms; Endometrial Neoplasms; Ignace de Hingh https://orcid.org/0000-0003-3491-4268 Uterine Cervical Neoplasms; Incidence; Epidemiology Anne van Altena https://orcid.org/0000-0003-2598-087X https://ejgo.org 1/12 Incidence and predictors of peritoneal metastases Presentation INTRODUCTION Poster presentation at the 17th Biennial Meeting of the International Gynecologic In 2015, over 4,000 women in the Netherlands were diagnosed with ovarian, endometrial Cancer Society (IGCS 2018). Kyoto, Japan, September 14–16, 2018. or cervical cancer [1]. Ovarian cancer is known to present with peritoneal metastases (PM) already at the time of diagnosis in a considerable number of patients. Due to the advanced Conflict of Interest stage at diagnosis it is associated with an impaired clinical outcome [2-4]: the overall 5-year No potential conflict of interest relevant to this survival rate is less than 30% [3-6]. In cervical and endometrial cancer, PM are less often article was reported. reported [7,8]. Author Contributions Conceptualization: V.A.A., B.D., B.L.; Data A better understanding of the biological behavior of gynecological cancers is of paramount curation: T.M., V.D.A.M.; Formal analysis: importance to improve treatment strategies. Analyzing the pattern of metastasis in T.M., R.K., B.L.; Methodology: T.M., R.K., B.L.; gynecological cancers and the predictive factors for having PM can contribute to the Software: T.M., R.K., B.L.; Validation: V.D.A.M.; Visualization: B.L.; Writing - original draft: B.L.; clarification of this behavior. Until recently, gynecological cancer patients were treated Writing - review & editing: T.M., V.D.A.M., B.D., according to the origin of the gynecological tumor, independent of other factors like R.K., D.H.I., V.A.A. histological type. Nowadays more attention is given to the differences between the histological subtypes of gynecological cancer and the pattern of metastases [9-11]. The histological subtype is expected to be a predictor for the occurrence of PM [12]. Nevertheless, more knowledge about predictive factors on PM is necessary. This is especially the case since promising therapeutic modalities are upcoming. To the best of our knowledge, no population-based studies on the incidence of PM in gynecological cancers have been conducted. In addition, predictive patient- and tumor characteristics for the development of PM of gynecological origin are not yet studied on a large scale. Therefore, we describe the incidence of PM in gynecological cancers and identify predictors that increase the probability of peritoneal spread, so we can contribute to an increasing clinical guidance into a more targeted treatment strategy for patients with gynecological cancers. MATERIALS AND METHODS 1. Data collection We conducted a retrospective study. All consecutive patients with primary ovarian (C56, C57, C48), endometrial (C54, C55) and cervical (C53) cancer diagnosed between 1989 and 2015 were identified from the Netherlands Cancer Registry (NCR) [13]. Registration in the NCR takes place based on notification of newly diagnosed malignancies in the Netherlands by the automated nationwide pathology archive (Pathological Anatomical National Automated Archive [PALGA]). Specially trained administrators of the NCR routinely extract information on patients and tumor characteristics from the medical records. Completeness of the NCR is estimated to be over 95% [14]. The data contained patient characteristics, such as date of diagnosis and age at diagnosis. Socio-economic status was based on a patient's postal area according to the Netherlands Institute for Social Research [15]. A medical history of other malignant (non-) gynecological tumors was derived from the NCR. The International Federation of Gynecology and Obstetrics (FIGO) stage was derived from the tumor, node, and metastasis (TNM) staging system and was based on postoperative findings for ovarian cancer and endometrial cancer. In cervical cancer patients, FIGO was https://ejgo.org https://doi.org/10.3802/jgo.2020.31.e58 2/12 Incidence and predictors of peritoneal metastases based on clinical staging, using all available medical information of the patients as accurately as possible including imaging techniques, scopies and biopsies. Moreover, if patients underwent neoadjuvant chemotherapy, stage was based on clinical findings again including imaging, scopies and biopsies in order to avoid downstaging in case of good response. Lymph node involvement and distant metastases were identified. In case patients did not undergo surgical treatment, FIGO stage, lymph node involvement and distant metastases were based on clinical information (such as imaging techniques). As such, this was not in all cases histologically confirmed. Type of histology was classified into groups based on the primary site of the tumor. 2. Statistical analyses Patients were distributed among period groups according to the year of diagnosis (1989–1994, 1995–2000, 2001–2005, 2005–2010, 2011–2015) and into age groups (18–49 years, 50–74 years, >75 years). Descriptive statistics were used to provide an overview of all patients with gynecological cancer. Early stage ovarian (FIGO stage I–IIa), endometrial (FIGO stage I–II) and cervical (FIGO stage I–II) cancer patients were excluded from further analyses, as by definition, they could not develop PM. Ovarian cancer patients with an unknown FIGO stage were included, as TNM was not registered within the NCR for primary peritoneal cancers until 2010. Endometrial and cervical cancer patients with an unknown FIGO stage were excluded. Crude and European standardized (European standardized rate) incidence rates of ovarian, endometrial and cervical cancer patients with PM were calculated. Since registration in the NCR expanded in 2005 for the localization of metastases, a subgroup analysis regarding age-adjusted incidence rates between
Load more

Recommended publications
  • Appendiceal Tumours and Pseudomyxoma Peritonei: Literature Review with PSOGI/EURACAN Clinical Practice Guidelines for Diagnosis and Treatment
    European Journal of Surgical Oncology xxx (xxxx) xxx Contents lists available at ScienceDirect European Journal of Surgical Oncology journal homepage: www.ejso.com Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment * K. Govaerts a, , 1, R.J. Lurvink b, 1, I.H.J.T. De Hingh b, K. Van der Speeten a, L. Villeneuve c, S. Kusamura d, V. Kepenekian e, M. Deraco d, O. Glehen f, B.J. Moran g, on behalf the PSOGI a Department of Surgical Oncology, Hospital Oost-Limburg, Genk, Belgium b Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands c Service de Recherche et Epidemiologie Cliniques, Pole^ de Sante Publique, Hospices Civils de Lyon, Lyon, France, EMR 3738, Lyon 1 University, Lyon, France d Department of Surgery, Peritoneal Surface Malignancy Unit, Fondazione IRCCS Instituto Nazionale Dei Tumori di Milano, Via Giacomo Venezian 1, Milano, Milan Cap, 20133, Italy e Service de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France, EMR 3738, Lyon 1 University, Lyon, France f Department of Digestive Surgery, Centre Hospitalier Lyon Sud, Lyon, France g Peritoneal Malignancy Institute, North-Hampshire Hospital, Basingstoke, UK article info abstract Article history: Pseudomyxoma Peritonei (PMP) is a rare peritoneal malignancy, most commonly originating from a Received 10 February 2020 perforated epithelial tumour of the appendix. Given its rarity, randomized controlled trials on treatment Accepted 12 February 2020 strategies are lacking, nor likely to be performed in the foreseeable future. However, many questions Available online xxx regarding the management of appendiceal tumours, especially when accompanied by PMP, remain unanswered.
    [Show full text]
  • The Long-Term Prognostic Significance of Circulating Tumor
    cancers Article The Long-Term Prognostic Significance of Circulating Tumor Cells in Ovarian Cancer—A Study of the OVCAD Consortium Eva Obermayr 1,* , Angelika Reiner 2 , Burkhard Brandt 3,4 , Elena Ioana Braicu 5, Alexander Reinthaller 1 , Liselore Loverix 6, Nicole Concin 7, Linn Woelber 8, Sven Mahner 8,9, Jalid Sehouli 5, Ignace Vergote 6 and Robert Zeillinger 1 1 Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria; [email protected] (A.R.); [email protected] (R.Z.) 2 Department of Pathology, Klinikum Donaustadt, 1090 Vienna, Austria; [email protected] 3 Institute of Tumor Biology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany; [email protected] 4 Institute of Clinical Chemistry, University Medical Center Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany 5 Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, 13353 Berlin, Germany; [email protected] (E.I.B.); [email protected] (J.S.) 6 Division of Gynecological Oncology, Department of Obstetrics and Gynecology, University Hospitals Leuven, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; [email protected] (L.L.); [email protected] (I.V.) 7 Department of Obstetrics and Gynecology, Innsbruck Medical University, 6020 Innsbruck, Austria; Citation: Obermayr, E.; Reiner, A.; [email protected] 8 Brandt, B.; Braicu, E.I.; Reinthaller, A.; Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Loverix, L.; Concin, N.; Woelber, L.; 20246 Hamburg, Germany; [email protected] (L.W.); [email protected] (S.M.) 9 Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany Mahner, S.; Sehouli, J.; et al.
    [Show full text]
  • Metastatic Ovarian Cancer to the Gallbladder Indicative of the Diagnosis
    MOJ Clinical & Medical Case Reports Case Report Open Access Metastatic ovarian cancer to the gallbladder indicative of the diagnosis Abstract Volume 11 Issue 1 - 2021 Ovarian cancer is a malignant tumor that usually develops from the surface coating of Soumia Berrad, Zineb Benbrahim,Vincent the ovaries. The most common form is epithelial carcinoma. As a result of its location, W Lokonga, Lamiae Nouiakh, Hayat Erraichi, and its silent nature responsible for a delay in diagnosis that makes the prognosis rather poor. The usual metastatic sites are the peritoneal cavity, liver and lung. Secondary biliary Lamiae Amaadour, Karima Oualla, Samia Arifi, localization is a rare, even exceptional site. We report the observation of a patient who Naoufal Mellas presented with abdominal pain in the right hypochondrium and progressive vomiting. Department of Medical Oncology, Hassan II Unversity Hospital, Abdominal ultrasound revealed a 21 mm gallbladder lithiasis with hepatic steatosis. Morocco Abdominal CT scan revealed a large heterogeneous mass with engulfed gallstones. The Correspondence: Soumia Berrad, Department of Medical patient underwent cholecystectomy. Histological study showed moderately differentiated Oncology, Hassan II Unversity Hospital, Morocco, adenocarcinoma and acute cholecystitis. Immunohistochemical staining revealed that the Email tumor cells were positive for antibodies against CK7, WT1, PAX8 and p53 and negative for CK20 and ER. These results suggest that the tumor was a metastasis of serous ovarian Received: December 20, 2020 | Published: January 25, 2021 adenocarcinoma. Medical imaging done with abdominal CT showed an ovarian mass with peritoneal carcinosis, serum CA125 was elevated at 97U/ml. Carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) levels were normal.
    [Show full text]
  • Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
    Original Article Hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant chemotherapy as prophylaxis of peritoneal carcinosis from advanced gastric cancer—effects on overall and disease free survival Federico Coccolini1, Andrea Celotti1, Marco Ceresoli1, Giulia Montori1, Michele Marini1, Fausto Catena2, Luca Ansaloni1 1General Surgery Department, Papa Giovanni XXIII Hospital, Bergamo, Italy; 2General and Emergency surgery, Parma Maggiore Hospital, Parma, Italy Contributions: (I) Conception and design: F Coccolini, A Celotti, L Ansaloni; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: A Celotti, M Marini, G Montori; (V) Data analysis and interpretation: F Coccolini, M Ceresoli, F Catena, L Ansaloni; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Federico Coccolini, MD. General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy. Email: [email protected]. Background: The possibility to enlarge criteria for intra-peritoneal chemotherapy (IPC) to all patients at high-risk to develop peritoneal carcinosis (i.e., with serosal invasion) is still discussed. Methods: Retrospective case-control study. Three-groups: advanced-gastric-cancer (AGC) (pT4) without proven carcinosis: prophylactic group (PG), those with PC: treatment group (TG), AGC (pT3–pT4) operated without hyperthermic intraperitoneal chemotherapy (HIPEC), surgery alone group (SG T3, SG T4). Results: Forty four patients. 26 (59.1%) were male. Sixteen (36%) patients underwent 16 HIPEC: 6 (38%) had AGC (pT4) without PC (PG), 10 (62%) had carcinosis (TG), 28 were operated without HIPEC (SG T3, SG T4). The mean disease free survival (DFS): TG: 7.7 months, SG T4: 21.6 months, SG T3: 27.7 months, PG: 34.5 months.
    [Show full text]
  • Intraperitoneal Chemotherapy for Peritoneal Metastases: Technical Innovations, Preclinical and Clinical Advances and Future Perspectives
    biology Review Intraperitoneal Chemotherapy for Peritoneal Metastases: Technical Innovations, Preclinical and Clinical Advances and Future Perspectives Niki Christou 1,2,3,* , Clément Auger 3 , Serge Battu 3, Fabrice Lalloué 3 , Marie-Odile Jauberteau-Marchan 3, Céline Hervieu 3 , Mireille Verdier 3 and Muriel Mathonnet 1,3 1 Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, 87042 Limoges CEDEX, France; [email protected] 2 Department of Visceral Surgery, Geneva University Hospitals and Medical School, Geneva, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland 3 Laboratoire EA 3842, CAPtuR, Contrôle de l’Activation Cellulaire, Progression Tumorale et Résistance Thérapeutique, Faculté de Médecine, 2 rue du Docteur Marcland, 87025 Limoges CEDEX, France; [email protected] (C.A.); [email protected] (S.B.); [email protected] (F.L.); [email protected] (M.-O.J.-M.); [email protected] (C.H.); [email protected] (M.V.) * Correspondence: [email protected]; Tel.: +33-684-569-392 Simple Summary: The aim of this review is to emphazise the evolution of intraperitoneal chemother- apy for peritoneal metastasis. Over the last past decade, both delivery modes and conditions concerning hyperthermic intra-abdominal chemotherapy have evolved aiming at improving global and recurrence-free survival of malignant peritoneal diseases. We are waiting now more large Citation: Christou, N.; Auger, C.; randomized controlled trials to demonstrate the efficacy of such treatments. Battu, S.; Lalloué, F.; Jauberteau-Marchan, M.-O.; Hervieu, Abstract: (1) Background: Tumors of the peritoneal serosa are called peritoneal carcinosis. Their C.; Verdier, M.; Mathonnet, M. origin may be primary by primitive involvement of the peritoneum (peritoneal pseudomyxoma, Intraperitoneal Chemotherapy for peritoneal mesothelioma, etc.).
    [Show full text]
  • A Case of Pseudomyxoma Peritonei in a 69Years Old Woman and Review of Literature
    MOJ Clinical & Medical Case Reports Case Report Open Access A case of pseudomyxoma peritonei in a 69years old woman and review of literature Abstract Volume 3 Issue 2 - 2015 Pseudomyxoma peritonei (PMP) is a rare neoplasm characterized by the production Danilo Coco,1 Silvana Leanza,2 Massimo of abundant mucin or gelatinous ascites with involvement of the peritoneal surface 1 and omentum. Usually it is associated with benign or malignant mucinous tumor of Giuseppe Viola 1Department of General Surgery, Giovanni Panico Hospital, Italy the appendix or ovary but there are also cases described with other side as colon, 2Department of General Surgery, INRCA Hospital, Italy rectum, stomach, gallbladder, biliary tract and so on The overall incidence is 1-2 per million per year, it is more common in women than in men (male: female ratio: 9:11). Correspondence: Danilo Coco, Department of General Signs and Symptoms of PMP are very a specific for this reason this disease is often Surgery, Giovanni Panico Hospital, Tricase, Italy, Tel +39 340 discovered incidentally during other surgical procedure or diagnostic procedure of 0546021, Email [email protected] other pathology. Treatment ranges from debulking to hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS). In this article we want to Received: October 6, 2015 | Published: November 5, 2015 describe a case of PMP discovered during a diagnostic laparoscopy in a 69years old woman with a specific symptoms and a diagnosis of peritoneal carcinomatosis at CT SCAN and to review the literature about this rare pathology. Keywords: pseudomyxoma peritonei, laparoscopy, carcinomatosis, mucinous tumor, carcinosis, peritonectomy, intraperitoneal, chemotherapy, abdominal pain, mytomicin C, adenocarcinoma Abbreviations: PMP, pseudomyxoma peritonei; HIPEC, of the appendix (Figure 2).
    [Show full text]
  • Peritoneal Carcinosis of Ovarian Origin
    Online Submissions: http://www.wjgnet.com/1948-5204office World J Gastrointest Oncol 2010 February 15; 2(2): 102-108 [email protected] ISSN 1948-5204 (online) doi:10.4251/wjgo.v2.i2.102 © 2010 Baishideng. All rights reserved. TOPIC HIGHLIGHT Antonio Macrì, MD, Professor, Series Editor Peritoneal carcinosis of ovarian origin Anna Fagotti, Valerio Gallotta, Federico Romano, Francesco Fanfani, Cristiano Rossitto, Angelica Naldini, Massimo Vigliotta, Giovanni Scambia Anna Fagotti, Valerio Gallotta, Federico Romano, Francesco Intraperitoneal hyperthermic chemotherapy; Cytore- Fanfani, Cristiano Rossitto, Angelica Naldini, Massimo duction Vigliotta, Giovanni Scambia, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, 100168, Peer reviewer: Francesco Fiorica, MD, Department of Radiation Rome, Italy Oncology, University Hospital S’Anna, Corso Giovecca 203, Author contributions: Fagotti A designed the paper; Fagotti A, Ferrara I-44100, Italy Gallotta V and Romano F wrote the paper; Fanfani F, Rossitto C, Naldini A and Vigliotta M performed data gathering; Scambia Fagotti A, Gallotta V, Romano F, Fanfani F, Rossitto C, Naldini A, G was the responsible surgeon and supervised the paper. Vigliotta M, Scambia G. Peritoneal carcinosis of ovarian origin. Correspondence to: Anna Fagotti, MD, Department of World J Gastrointest Oncol 2010; 2(2): 102-108 Available Obstetrics and Gynecology, Catholic University of the Sacred from: URL: http://www.wjgnet.com/1948-5204/full/v2/i2/ Heart, L. go A. Gemelli, 100168, Rome, Italy. [email protected] 102.htm DOI: http://dx.doi.org/10.4251/wjgo.v2.i2.102 Telephone: +39-6-30154979 Fax: +39-6-30154979 Received: July 31, 2009 Revised: October 2, 2009 Accepted: October 9, 2009 Published online: February 15, 2010 INTRODUCTION Epithelial ovarian cancer is the second most common genital malignancy in women and it is the most lethal gynecological malignancy, with an estimated five-year sur- Abstract [1] vival rate of 39% .
    [Show full text]
  • Impact of Open Laparoscopy in Patients Under Suspicion of Ovarian Cancer
    ANTICANCER RESEARCH 36: 3459-3464 (2016) Impact of Open Laparoscopy in Patients Under Suspicion of Ovarian Cancer LARS SCHRÖDER, CHRISTIAN RUDLOWSKI, PAULA KUTKUHN, ALINA ABRAMIAN, CHRISTINA KAISER, WALTHER CHRISTIAN KUHN and MIGNON-DENISE KEYVER-PAIK Department of Gynecology and Obstetrics, Center for Integrated Oncology (CIO) Köln/Bonn, University Hospital Bonn, Bonn, Germany Abstract. Background/Aim: Feasibility and value of transvaginal and abdominal ultrasonography, and diagnostic open laparoscopy (DOL) was assessed in patients measurement of the tumor markers [e.g. cancer antigen 125 presenting under suspicion of advanced ovarian cancer (CA 125) and carcinoembryonic antigen (CEA) (3, 4). To (AOC) mostly with large-volume ascites. Patients and generate further information, additional radiological studies Methods: This retrospective study analyzed 143 consecutive such as a computed-tomography (CT) (5, 6) a magnetic patients who underwent DOL for histopathological resonance imaging (MRI) (7) or positron-emission verification of AOC performed from 2002 to 2012. Results: tomography (PET/CT) can be performed (8). Out of the 143 patients presenting at our Center with an Therapeutic strategies include optimal cytoreductive surgery ovarian mass and mostly with ascites under suspicion of (“no residual tumor”) and a platinum- and taxane-based ovarian cancer, we diagnosed 125 AOCs, three AOCs with chemotherapy. Chronological sequence of surgery and three concomitant tumors of other origin, and 15 other chemotherapy can vary (adjuvant or neoadjuvant regimen). diseases causing an ovarian mass and ascites mimicking For patients who are thought to have operable disease, lack of AOC (e.g. gastrointestinal malignancies, tuberculosis, ascites and a good performance status primary debulking mesothelioma, endometrial cancer and benign conditions).
    [Show full text]
  • Strategy for the Management and Prognosis of Ovarian Cancer in Sub-Saharan Africa: Experience from the National Hospital Center of Pikine, Dakar-Senegal
    Journal of Gynecology and Women’s Health ISSN 2474-7602 Research Article J Gynecol Women’s Health Volume 18 Issue 3- February 2020 Copyright © All rights are reserved by Moussa Diallo DOI: 10.19080/JGWH.2020.18.555986 Strategy for the Management and Prognosis of Ovarian Cancer in Sub-Saharan Africa: Experience from the National Hospital Center Of Pikine, Dakar-Senegal Moussa Diallo*, Abdoul Aziz Diouf, Mamour Gueye, Aïssatou Mbodji, Aminata Niass, Cyr Espérence Gombet Koulimaya and Jacques Raiga et Alassane Diouf Department of Obstetrics and Gynaecology, National Hospital of Pikine, Senegal Submission: January 24, 2020; Published: February 10, 2020 *Corresponding author: Moussa Diallo, Department of Obstetrics and Gynaecology, National Hospital of Pikine, Senegal Abstract Objective : To assess the management of advanced ovarian cancer at the Pikine National Hospital Center and to assess his prognosis. Patients and methods : This is a prospective collection on the surgical management of ovarian cancer between July 2017 and March 2019. This study took place in the Gynecology and Obstetrics department of the National Hospital Center of Pikine. This prospective study brings together the first 37 cases of ovarian cancer managed by optimal surgery. Included were all patients with an ovarian tumor whose diagnosis had hadbeen not made been either made. after a search for malignant cells in the ascites fluid, or after a histological examination of a biopsy sample by laparoscopy. Were not included in our study, patients who did not benefit from a neither optimal or delayed cytoreductive surgery, or those whose formal diagnosis Result : The average age of the patients was 54 years with extremes of 31 and 79 years.
    [Show full text]
  • Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Malignancies Using New Hybrid ­CO2 System: Preliminary Experience in Referral Center
    Updates in Surgery (2019) 71:555–560 https://doi.org/10.1007/s13304-018-0578-5 ORIGINAL ARTICLE Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies using new hybrid ­CO2 system: preliminary experience in referral center Stefano Cianci1 · Carlo Abatini2 · Anna Fagotti3 · Benito Chiofalo4 · Alessandro Tropea5 · Antonio Biondi5 · Giovanni Scambia3 · Fabio Pacelli6 Received: 3 July 2018 / Accepted: 3 August 2018 / Published online: 9 August 2018 © Italian Society of Surgery (SIC) 2018 Abstract The most frequent peritoneal surface malignancies originate principally by gastric cancer, colorectal cancer and ovarian cancer. Apart from the origin, peritoneal carcinosis (PC) is considered a negative prognostic factor. The hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal malignancies is considered an attractive method to deliver chemotherapy with enhanced efect directly at the tumor site. The use of such loco-regional approach has proved to improve prognosis of peritoneal carcinomatosis from diferent origins. Recently, new devices are suitable for loco-regional intraperitoneal chemotherapy as Peritoneal Recirculation System (PRS-1.0 Combat) with CO­ 2 technology. This is a retrospective study with the aim to assess the perioperative outcomes using PRS. Seventeen patients were enrolled afected by colorectal or ovarian cancer. Complete cytoreduction (RT = 0) was achieved for all cases. Median operative time was 420 min (range: 335–665) and median drugs dose used for HIPEC was 137 mg/m2 (115–756). Median EBL was 200 ml (range 50–1000). Median post-operative hospital stay was 9 days (range: 4–24). Treatment-related early complications were recorded in 8 (47.0%) cases and were G1–G2 Major complications occurred in two (11.7%) cases.
    [Show full text]
  • Colorectal and Appendiceal Peritoneal Metastases
    Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1441 Colorectal and appendiceal peritoneal metastases From population studies to genetics MALIN ENBLAD ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-513-0266-9 UPPSALA urn:nbn:se:uu:diva-340059 2018 Dissertation presented at Uppsala University to be publicly examined in Grönwallsalen, Akademiska sjukhuset, ingång 70, bv, Uppsala, Saturday, 5 May 2018 at 09:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in Swedish. Faculty examiner: Associate professor Peter Matthiessen (Örebro University, Sweden). Abstract Enblad, M. 2018. Colorectal and appendiceal peritoneal metastases. From population studies to genetics. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1441. 67 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0266-9. Peritoneal dissemination of colorectal and appendiceal origin was previously considered the end-stage of malignant disease. Today, treatment with cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC) has prolonged survival and cured some patients with peritoneal metastases (PM). Unfortunately, a majority of patients still have fatal outcomes. In this thesis, colorectal and appendiceal PM were studied from a wide population-based perspective down to the detailed perspectives of histopathology and genetics, with the aim of further contributing to prolonged survival. In Paper I, the heterogeneous histopathology of PM was investigated and a substantial proportion of patients undergoing CRS and HIPEC were found to have surgical specimens lacking neoplastic epithelium. These patients had a favourable prognosis and the results illustrate the importance of thorough analysing and reporting of histopathology for understanding differences in survival outcomes and for improving patient selection.
    [Show full text]
  • Allosteric and ATP-Competitive MEK-Inhibition in a Novel Spitzoid Melanoma Model with a RAF- and Phosphorylation-Independent Mutation
    cancers Article Allosteric and ATP-Competitive MEK-Inhibition in a Novel Spitzoid Melanoma Model with a RAF- and Phosphorylation-Independent Mutation Luca Hegedüs 1, Özlem Okumus 1 , Elisabeth Livingstone 2, Marcell Baranyi 3, Ildikó Kovács 4, Balázs Döme 4,5,6, József Tóvári 7, Ágnes Bánkfalvi 8, Dirk Schadendorf 2, Clemens Aigner 1 and Balázs Hegedüs 1,* 1 Department of Thoracic Surgery, University Medicine Essen–Ruhrlandklinik, Tüschener Weg 40, 45239 Essen, Germany; [email protected] (L.H.); [email protected] (Ö.O.); [email protected] (C.A.) 2 Department of Dermatology, University Medicine Essen, Esmarchstraße 14, 45147 Essen, Germany; [email protected] (E.L.); [email protected] (D.S.) 3 2nd Department of Pathology, Semmelweis University, Üll˝oi út 93, 1091 Budapest, Hungary; [email protected] 4 National Korányi Institute of Pulmonology, Pihen˝o út 1, 1122 Budapest, Hungary; [email protected] (I.K.); [email protected] (B.D.) 5 Department of Thoracic Surgery, National Institute of Oncology, Ráth György u. 7-9, 1122 Budapest, Hungary 6 Department of Thoracic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria 7 Department of Experimental Pharmacology, National Institute of Oncology, Ráth György u. 7-9, 1122 Budapest, Hungary; [email protected] 8 Department of Pathology, University Medicine Essen, Hufelandstraße 55, 45147 Essen, Germany; Citation: Hegedüs, L.; Okumus, Ö.; [email protected] Livingstone, E.; Baranyi, M.; Kovács, * Correspondence: [email protected]; Tel.: +49-201-433-4665; Fax: +49-201-433-4019 I.; Döme, B.; Tóvári, J.; Bánkfalvi, Á.; Schadendorf, D.; Aigner, C.; et al.
    [Show full text]