Surgical approach to diaphragmatic metastases from ovarian cancer

Deppe, Gunter; Malviya, Vinay K.; Boike, Guy M.; Hampton, Alfreda

doi:10.1016/0090-8258(86)90034-x

Cited by 29 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With this extensive surgery, rates of complete cytoreduction reported in the literature ranged from 16% to 89%. [6][7][8][9][10][11][12][13][14] In this study, we achieved similar rates: 68% of intestinal resections, 33% of splenectomies, 76% of pelvic and para-aortic lymphadenectomies, and 95% of complete cytoreduction.…”

Section: Fromsupporting

confidence: 61%

“…These results are in agreement with previous studies that reported a pneumothorax rate ranging from 0% to 33% and a rate of secondary chest-tube drainage ranging from 7% to 27%. [7][8][9][10][11][12][13][14] Our findings suggest 3 important points. First, when DS is feasible, we can obtain complete cytoreduction at the time of INS or IDS in the majority of cases (95%).…”

Section: Frommentioning

confidence: 63%

“…The right hemidiaphragm was more frequently involved in all studies. [7][8][9][10][11][12][13][14] However, a higher rate of bilateral DS was reported in the studies with a higher rate of complete cytoreduction. In our institution, we performed bilateral DS in 50% of the cases to obtain a 95% rate of complete cytoreduction.…”

Section: Frommentioning

confidence: 87%

See 2 more Smart Citations

Surgical Procedures and Morbidities of Diaphragmatic Surgery in Patients Undergoing Initial or Interval Debulking Surgery for Advanced-Stage Ovarian Cancer

Gouy

Chéreau

Custódio

et al. 2010

Journal of the American College of Surgeons

View full text Add to dashboard Cite

BACKGROUND: Surgical management of advanced-stage ovarian cancer (ASOC) can require diaphragmatic surgery (DS) to achieve complete cytoreduction. The aim of this study was to evaluate modalities and morbidities of DS at the time of initial surgery (INS) and interval debulking surgery (IDS; performed after neoadjuvant chemotherapy). STUDY DESIGN: Retrospective review of patients undergoing (unilateral or bilateral) DS at the time of INS or IDS for ASOC.

show abstract

Section: Fromsupporting

confidence: 61%

Section: Frommentioning

confidence: 63%

See 1 more Smart Citation

Surgical Procedures and Morbidities of Diaphragmatic Surgery in Patients Undergoing Initial or Interval Debulking Surgery for Advanced-Stage Ovarian Cancer

Gouy

Chéreau

Custódio

et al. 2010

Journal of the American College of Surgeons

View full text Add to dashboard Cite

show abstract

“…Unfortunately, two-thirds of the patients with advanced ovarian cancer cannot be optimally debulked (Schwartz, 1997) because of unresectable, bulky tumours in the cul-de-sac or upper abdomen, or due to retroperitoneal tumours adherent to major abdominal vessels (Gershenson, 1994). Electrocautery (Deppe et al, 1986), argon beam coagulator (Brand and Pearlman, 1990), Cavitron Ultrasonic Surgical Aspirator (CUSA) (Deppe et al, 1990) and neodymium-yttrium-aluminium-garnet (Nd-YAG) lasers (Brand et al, 1988) are used to improve cytoreductive surgery. Most of these techniques require an open surgical procedure, none are selective for cancerous tissue, and their beneficial impact on cytoreduction remains unproven (Gershenson, 1994).…”

mentioning

confidence: 99%

Minimally-invasive debulking of ovarian cancer in the rat pelvis by means of photodynamic therapy using the pegylated photosensitizer PEG-m-THPC

et al. 1999

View full text Add to dashboard Cite

Summary Interstitial photodynamic therapy (PDT) using the pegylated photosensitizer PEG-m-THPC was evaluated as a minimally-invasive procedure to selectively debulk unrespectable pelvic ovarian cancer (NuTu-19) in immunocompetent rats. To assess tumour selectivity, PEGm-THPC at dosages of 0.3, 3.0 and 30 mg kg -1 body weight was administered intravenously to 30 rats 4 weeks following tumour induction. Eight days later laser light at 652 nm and optical doses ranging from 100 to 900 J cm -1 diffuser-length was delivered by an interstitial cylindrical diffusing fibre inserted blindly into the pelvis. Three days following light application, the volume of necrosis was measured and the damage to pelvic organs was assessed histologically on cross sections. For analysis of survival, 20 tumour-bearing rats received PDT using drug doses of 3 or 9 mg kg -1 body weight and an optical dose of 900 J cm -1 diffuser-length, whereas ten untreated tumour-bearing rats served as controls. The histological assessment of PDT induced necrosis showed a non-linear dose-response for both the photosensitizer dose and the optical dose. The lowest drug dose activated with the highest optical dose did not induce more necrosis than seen in tumour-bearing control animals. The same optical dose induced necrosis of 17 mm in diameter using 30 mg kg -1 and 11 mm using 3 mg kg -1 photosensitizer. The optical threshold for induction of significant necrosis was between 100 and 300 J cm -1 diffuser-length for 30 mg kg -1 and between 300 and 500 J cm -1 for 3 mg kg -1 PEG-m-THPC. Significant damage to normal pelvic organs was only seen if 30 mg kg -1 photosensitizer was activated with optical doses of 700 J cm -1 or more. In the survival study, all treated animals survived PDT for at least 2 weeks and the intestinal and urinary tract remained functional. No clinical signs of blood vessel or nerve injury were observed. Mean overall survival of untreated tumour-bearing rats was 25.0 ± 4.5 days compared to 38.4 ± 3.8 days and 40.0 ± 3.6 days for rats treated with 3 mg kg -1 or 9 mg kg -1 PEG-m-THPC mediated PDT respectively (P < 0.05). We conclude that PEG-m-THPC mediated PDT has a favourable therapeutic window and that this minimally-invasive procedure can reduce pelvic cancer bulks effectively and selectively.

show abstract

“…The diaphragmatic implants can be resected with various surgical techniques, as ABC, peritonectomy or muscle resection. As previously suggested [112], [115]. The complete understanding of the upper abdominal anatomy and of the liver mobilization maneuvers are essential to allow exploration and radical debulking of the diaphragm, and minimizing the risk of major vessels injuries (retro-hepatic caval vein, supra-hepatic veins, diaphragmatic vessels) with severe haemorrhage.…”

Section: Laparooscopic Assisted Diaphragmatic and Hepatic Surgery In mentioning

confidence: 99%

Minimally Invasive Surgical Procedures for Patients with Advanced and Recurrent Ovarian Cancer

Farghaly¹

2012

Ovarian Cancer - Clinical and Therapeutic Perspectives

View full text Add to dashboard Cite

Surgical approach to diaphragmatic metastases from ovarian cancer

Cited by 29 publications

References 0 publications

Surgical Procedures and Morbidities of Diaphragmatic Surgery in Patients Undergoing Initial or Interval Debulking Surgery for Advanced-Stage Ovarian Cancer

Surgical Procedures and Morbidities of Diaphragmatic Surgery in Patients Undergoing Initial or Interval Debulking Surgery for Advanced-Stage Ovarian Cancer

Minimally-invasive debulking of ovarian cancer in the rat pelvis by means of photodynamic therapy using the pegylated photosensitizer PEG-m-THPC

Minimally Invasive Surgical Procedures for Patients with Advanced and Recurrent Ovarian Cancer

Contact Info

Product

Resources

About