Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 28;21(1):269.
doi: 10.1186/s12957-023-03153-z.

Prognostic value of peritoneal scar-like tissue in patients with peritoneal metastases of ovarian origin presenting for curative-intent cytoreductive surgery

Antoine El Asmar  1 , Florin Pop  2 , Etienne El Helou  2 , Pieter Demetter  3 , Isabelle Veys  2 , Laura Polastro  4 , Ali Bohlok  2 , Gabriel Liberale  2
Affiliations

Prognostic value of peritoneal scar-like tissue in patients with peritoneal metastases of ovarian origin presenting for curative-intent cytoreductive surgery

Antoine El Asmar et al. World J Surg Oncol. .

Abstract

Background: Complete cytoreductive surgery (CRS), remain the gold standard in the treatment of peritoneal metastases of ovarian cancer (PMOC). Given the increasing rate of neoadjuvant chemotherapy in patients with high PCI, prior abdominal surgeries, inflammation and fibrotic changes, the benefit of removing any "peritoneal scar-like tissues" (PST) during CRS, hasn't been thoroughly investigated. Our objective in this retrospective cohort was to identify the proportion of malignant cells positivity in PST of patients with PMOC, undergoing curative-intent CRS ± HIPEC.

Methods: This is a retrospective study, conducted at our comprehensive cancer center, including patients with PMOC, presenting for curative-intent CRS. During CRS, benign-looking peritoneal lesions, lacking the typical hard nodular, aggressive, and invasive morphology, were systematically resected or electro fulgurated. PSTs were analyzed for the presence of tumoral cells by our pathologist. Correlations between the presence of PST and their positivity, and the different patients' variables, were studied.

Results: In 51% of patients, PST harbored malignant cells. Those were associated with poorly differentiated serous tumors, a high PCI (> 8) and a worse DFS: 17 months in the positive PST group versus 29 months in the negative PST group (p = 0.05), on univariate analysis. Multivariate analysis revealed that PCI > 8 and poorly differentiated primary tumor histology were correlated with a worse DFS, and that higher PCI and advanced FIGO were correlated with a worse OS.

Conclusion: Benign-looking PST harbors malignancy in 51% of cases. The benefit of their systematic resection and their prognostic value should be further investigated in larger cohorts.

Keywords: Cytoreductive surgery; Ovarian cancer; Peritoneal carcinomatosis; Peritoneal fibroses; Prognostic factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Benign peritoneal scar-like tissue (A) versus malignant peritoneal scar-like tissue (B), as confirmed by pathology examination, on the mesocolon of a patient presenting with PMOC
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. van Baal JOAM, van Noorden CJF, Nieuwland R, et al. Development of peritoneal carcinomatosis in epithelial ovarian cancer: a review. J Histochem Cytochem. 2018;66(2):67–83. doi: 10.1369/0022155417742897. - DOI - PMC - PubMed
    1. Lockley M, Brockbank E, Fitzpatrick A. Chemotherapy response score: development and validation of a system to quantify histopathologic response to neoadjuvant chemotherapy in tubo-ovarian High-Grade Serous Carcinoma Gynaecological pathology book View project Cochrane review view project Asma Faruqi Barts health NHS trust. Article J Clinic Oncol. Published online 2015. 10.1200/JCO.2014.60.5212. - PubMed
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34. doi: 10.3322/CAAC.21551. - DOI - PubMed
    1. Du BA, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the arbeitsgemeinschaft gynaekologische onkologie studiengruppe ovarialkarzinom (AGO-OVAR) and the groupe d’Investigateurs nationaux pour les etudes des cancers de l’Ovaire (GINECO) Cancer. 2009;115(6):1234–1244. doi: 10.1002/CNCR.24149. - DOI - PubMed
    1. Vergote I, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. 2010;363(10):943–53. - PubMed