Analysis of factors impacting operability in stage IV ovarian cancer

Rationale use of a triage system

Giovanni D. Aletti, Sean Christopher Dowdy, Karl C. Podratz, William Arthur Cliby

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objectives.: Determine impact of tumor distribution and surgery on prognosis in patients with stage IV epithelial ovarian cancer (EOC). Methods.: Retrospective analysis of stage IV EOC patients undergoing primary surgery between 1994 and 1998. Simple statistics, univariate and multivariable analysis were performed. Results.: Forty-nine patients met the inclusion criteria and entered the study. Five-year overall survival (OS) was 18.2%. Residual disease (RD) and radical surgical procedures (RSP) independently predicted survival (p < 0.001). Optimal debulking rate (RD < 1 cm) was 49% and median survival for optimal patients was 3.2 years. A very high risk group of patients based on extent of peritoneal disease, parenchymal liver metastases and ASA could be identified in whom the rate of optimal debulking was less than 25% (median survival 1.4 years). No patients with multiple liver metastases were optimally cytoreduced and the median survival was 1 year. Conclusions.: Based on patient factors and extent of disease, a high risk group of patients can be identified with a poor prognosis and low probability of optimal debulking. It appears justified in these patients to first exclude those with unresectable pleural disease and then perform laparoscopic assessment to determine extent of disease to triage patients to alternative strategies such as neoadjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)84-89
Number of pages6
JournalGynecologic Oncology
Volume105
Issue number1
DOIs
StatePublished - Apr 2007

Fingerprint

Triage
Ovarian Neoplasms
Statistical Factor Analysis
Survival
Peritoneal Diseases
Pleural Diseases
Neoplasm Metastasis
Liver
Drug Therapy

Keywords

  • Aggressive surgery
  • Ovarian cancer
  • Prognosis
  • Resectability
  • Stage IV

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Analysis of factors impacting operability in stage IV ovarian cancer : Rationale use of a triage system. / Aletti, Giovanni D.; Dowdy, Sean Christopher; Podratz, Karl C.; Cliby, William Arthur.

In: Gynecologic Oncology, Vol. 105, No. 1, 04.2007, p. 84-89.

Research output: Contribution to journalArticle

@article{2f8c9f5b670141128c10c05bf4a57dd3,
title = "Analysis of factors impacting operability in stage IV ovarian cancer: Rationale use of a triage system",
abstract = "Objectives.: Determine impact of tumor distribution and surgery on prognosis in patients with stage IV epithelial ovarian cancer (EOC). Methods.: Retrospective analysis of stage IV EOC patients undergoing primary surgery between 1994 and 1998. Simple statistics, univariate and multivariable analysis were performed. Results.: Forty-nine patients met the inclusion criteria and entered the study. Five-year overall survival (OS) was 18.2{\%}. Residual disease (RD) and radical surgical procedures (RSP) independently predicted survival (p < 0.001). Optimal debulking rate (RD < 1 cm) was 49{\%} and median survival for optimal patients was 3.2 years. A very high risk group of patients based on extent of peritoneal disease, parenchymal liver metastases and ASA could be identified in whom the rate of optimal debulking was less than 25{\%} (median survival 1.4 years). No patients with multiple liver metastases were optimally cytoreduced and the median survival was 1 year. Conclusions.: Based on patient factors and extent of disease, a high risk group of patients can be identified with a poor prognosis and low probability of optimal debulking. It appears justified in these patients to first exclude those with unresectable pleural disease and then perform laparoscopic assessment to determine extent of disease to triage patients to alternative strategies such as neoadjuvant chemotherapy.",
keywords = "Aggressive surgery, Ovarian cancer, Prognosis, Resectability, Stage IV",
author = "Aletti, {Giovanni D.} and Dowdy, {Sean Christopher} and Podratz, {Karl C.} and Cliby, {William Arthur}",
year = "2007",
month = "4",
doi = "10.1016/j.ygyno.2006.10.055",
language = "English (US)",
volume = "105",
pages = "84--89",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

}

TY - JOUR

T1 - Analysis of factors impacting operability in stage IV ovarian cancer

T2 - Rationale use of a triage system

AU - Aletti, Giovanni D.

AU - Dowdy, Sean Christopher

AU - Podratz, Karl C.

AU - Cliby, William Arthur

PY - 2007/4

Y1 - 2007/4

N2 - Objectives.: Determine impact of tumor distribution and surgery on prognosis in patients with stage IV epithelial ovarian cancer (EOC). Methods.: Retrospective analysis of stage IV EOC patients undergoing primary surgery between 1994 and 1998. Simple statistics, univariate and multivariable analysis were performed. Results.: Forty-nine patients met the inclusion criteria and entered the study. Five-year overall survival (OS) was 18.2%. Residual disease (RD) and radical surgical procedures (RSP) independently predicted survival (p < 0.001). Optimal debulking rate (RD < 1 cm) was 49% and median survival for optimal patients was 3.2 years. A very high risk group of patients based on extent of peritoneal disease, parenchymal liver metastases and ASA could be identified in whom the rate of optimal debulking was less than 25% (median survival 1.4 years). No patients with multiple liver metastases were optimally cytoreduced and the median survival was 1 year. Conclusions.: Based on patient factors and extent of disease, a high risk group of patients can be identified with a poor prognosis and low probability of optimal debulking. It appears justified in these patients to first exclude those with unresectable pleural disease and then perform laparoscopic assessment to determine extent of disease to triage patients to alternative strategies such as neoadjuvant chemotherapy.

AB - Objectives.: Determine impact of tumor distribution and surgery on prognosis in patients with stage IV epithelial ovarian cancer (EOC). Methods.: Retrospective analysis of stage IV EOC patients undergoing primary surgery between 1994 and 1998. Simple statistics, univariate and multivariable analysis were performed. Results.: Forty-nine patients met the inclusion criteria and entered the study. Five-year overall survival (OS) was 18.2%. Residual disease (RD) and radical surgical procedures (RSP) independently predicted survival (p < 0.001). Optimal debulking rate (RD < 1 cm) was 49% and median survival for optimal patients was 3.2 years. A very high risk group of patients based on extent of peritoneal disease, parenchymal liver metastases and ASA could be identified in whom the rate of optimal debulking was less than 25% (median survival 1.4 years). No patients with multiple liver metastases were optimally cytoreduced and the median survival was 1 year. Conclusions.: Based on patient factors and extent of disease, a high risk group of patients can be identified with a poor prognosis and low probability of optimal debulking. It appears justified in these patients to first exclude those with unresectable pleural disease and then perform laparoscopic assessment to determine extent of disease to triage patients to alternative strategies such as neoadjuvant chemotherapy.

KW - Aggressive surgery

KW - Ovarian cancer

KW - Prognosis

KW - Resectability

KW - Stage IV

UR - http://www.scopus.com/inward/record.url?scp=33947316123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947316123&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2006.10.055

DO - 10.1016/j.ygyno.2006.10.055

M3 - Article

VL - 105

SP - 84

EP - 89

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 1

ER -