Intrathoracic surgery as part of primary cytoreduction for advanced ovarian cancer: The evolution of a “pelvic” surgeon

Fotopoulou, Christina

doi:10.1016/j.ygyno.2023.02.011

Gynecologic Oncology

2023

DOI: 10.1016/j.ygyno.2023.02.011

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Intrathoracic surgery as part of primary cytoreduction for advanced ovarian cancer: The evolution of a “pelvic” surgeon

Christina Fotopoulou¹

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Cited by 4 publications

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Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State

Kahn,

Ma,

Gordhandas

et al. 2024

Gynecologic Oncology

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Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State

Kahn,

Ma,

Gordhandas

et al. 2024

Gynecologic Oncology

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Extra-abdominal cytoreductive techniques in ovarian cancer: how far can (should) we go?

Kahn,

Chang,

Chi

2024

Int J Gynecol Cancer

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Complex surgery is an essential component in the management of advanced ovarian cancer. Furthermore, achieving complete gross resection in cytoreductive surgery appears to be associated with significant survival benefits in patients with advanced ovarian cancer. The goal of this review is to demonstrate the advancement of surgical techniques in gynecologic oncology surgery, including resection of disease within the intrathoracic and inguinal regions. This progress has expanded the option of surgery to more patients, especially those who would have previously been deemed inoperable. In this review we describe the most notable studies and reports of surgical resection of ovarian cancer involving cardiophrenic/supradiaphragmatic lymph nodes, mediastinum, lung pleura or parenchyma, and the inguinal region. We also describe the growing role that video-assisted thoracic surgery has played in advanced ovarian cancer diagnosis and management. The studies, series, and reports described demonstrate that comprehensive surgical procedures outside of the abdomen or pelvis can be both safe and feasible in properly selected patients. They also suggest that resection of disease outside of the abdomen or pelvis may benefit appropriately selected patients. Future studies are necessary to identify which patients may benefit most from upfront surgery versus neoadjuvant chemotherapy when ovarian cancer metastasis is present in the thoracic or inguinal regions.

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The Cukurova score in the prediction of primary cytoreduction in ovarian cancer

Khatib,

Seyfettinoglu,

Kose

et al. 2023

Int J Gynecol Cancer

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ObjectivePrimary debulking surgery has been the preferred surgical route and is still considered a quality indicator for advanced ovarian cancer surgery. However, a significant number of patients are not amenable to upfront surgery. Neoadjuvant chemotherapy and interval debulking surgery may be the most suitable approach for this group. This study aimed to evaluate a novel score for prediction of the cytoreduction results at primary debulking surgery for ovarian cancer patients.MethodsThis observational prospective study was conducted at a tertiary gynecologic oncology center between December 2020 and August 2022. Presumed primary stage III-IV epithelial ovarian carcinoma cases were included. Borderline tumors, and metastatic or non-epithelial ovarian malignancies, were excluded. Based on imaging findings, points were assigned to each anticipated surgical procedure required for complete cytoreduction. The sum of these points was multiplied by the patient’s Eastern Cooperative Oncology Group (ECOG) score, and thus, the Cukurova-clinic score was established. Furthermore, the required surgical procedures based on laparoscopic evaluation were recorded, and the score was readjusted and calculated to obtain the Cukurova score.ResultsOne hundred and fourteen patients were included in the study. Primary debulking surgery was performed in 70% of cases. Among them, complete cytoreduction (Cukurova score ≤12) was obtained in 97.3% of cases. Complete cytoreduction was not achieved in cases with Cukurova score >12. The odds ratio of 90-day mortality was 13.4 for patients with Cukurova score >12, compared with those with Cukurova score ≤12.ConclusionThe Cukurova score is a model for classifying advanced ovarian cancer patients who may be candidates for primary debulking surgery.

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Intrathoracic surgery as part of primary cytoreduction for advanced ovarian cancer: The evolution of a “pelvic” surgeon

Cited by 4 publications

References 24 publications

Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State

Regionalizing ovarian cancer cytoreduction to high-volume centers and the impact on patient travel in New York State

Extra-abdominal cytoreductive techniques in ovarian cancer: how far can (should) we go?

The Cukurova score in the prediction of primary cytoreduction in ovarian cancer

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