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. 2019 Aug;8(10):4598-4604.
doi: 10.1002/cam4.2377. Epub 2019 Jun 26.

Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high-grade serous carcinoma

Naoki Kojima  1 , Hiroshi Yoshida  1 , Ikumi Kuno  2 , Takashi Uehara  2 , Masaya Uno  2 , Mitsuya Ishikawa  2 , Tomoyasu Kato  2
Affiliations

Prognostic impact of intraoperative peritoneal cytology in interval debulking surgery for pelvic high-grade serous carcinoma

Naoki Kojima et al. Cancer Med. 2019 Aug.

Abstract

Background and objectives: The aim of this study was to determine whether peritoneal washing cytology (PWC) during interval debulking surgery (IDS) could predict the prognosis of patients with pelvic high-grade serous carcinoma (HGSC) achieving R0 status.

Methods: Between January 2007 and May 2018, 110 patients with ovarian/tubal/primary peritoneal HGSC received platinum-based neo-adjuvant chemotherapy, followed by IDS at National Cancer Center Hospital, Japan. All the patients achieved R0 debulking status, defined as no macroscopic residual tumor in the peritoneal cavity at the completion of IDS. PWC was performed before debulking during IDS. The survival outcomes were compared between the PWC-positive and PWC-negative groups.

Results: The median progression free survival (PFS) for the entire cohort was 17 months (range, 5-133 months). The median PFS for the PWC-positive group was significantly shorter than that of the PWC-negative group (16 vs 19 months, HR 2.04, 95% CI 1.22-3.41, P-value < 0.01). Increased risk of progression was observed on both univariate and multivariate analyses, including age and FIGO stage (HR 2.28; 95% CI 1.35-3.84, P < 0.01).

Conclusions: The positive PWC during IDS was found to predict earlier disease recurrence in patients with pelvic HGSC achieving R0 status. As performing PWC during IDS becomes standard practice, prospective validation should be conducted in the future.

Keywords: high-grade serous carcinoma; interval debulking surgery; no macroscopic residual disease; ovarian cancer; peritoneal washing cytology.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Pathological findings of a representative case with positive peritoneal washing cytology. A and B, Histological findings of primary tumor. C, Papanicolaou staining of peritoneal fluid, D, Immunocytostaining shows positivity for BerEP4, an epithelial marker
Figure 2
Figure 2
Survival analysis of patients with pelvic high‐grade serous carcinoma achieving R0 status. A, Progression‐free‐survival curves using the Kaplan‐Meier method according to intraoperative peritoneal cytology and log‐rank P‐values. B, Overall‐survival curves using the Kaplan‐Meier method according to intraoperative peritoneal cytology and log‐rank P‐values
See this image and copyright information in PMC

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