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. 2024 Aug:187:80-84.
doi: 10.1016/j.ygyno.2024.05.009. Epub 2024 May 11.

Trends in specific procedures performed at the time of cytoreduction for ovarian cancer: Is interval debulking surgery truly less radical? A Memorial Sloan Kettering Cancer Center Team Ovary study

Olga T Filippova  1 , Katherine Boecking  2 , Vance Broach  3 , Ginger J Gardner  3 , Yukio Sonoda  3 , Dennis S Chi  3 , Oliver Zivanovic  3 , Kara Long Roche  4
Affiliations

Trends in specific procedures performed at the time of cytoreduction for ovarian cancer: Is interval debulking surgery truly less radical? A Memorial Sloan Kettering Cancer Center Team Ovary study

Olga T Filippova et al. Gynecol Oncol. 2024 Aug.

Abstract

Objectives: To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer.

Methods: Patients surgically treated at our institution for newly diagnosed stage IIIC/IV epithelial ovarian cancer between 6/1/2015-12/31/2021 were identified using a prospectively collected database. Patients were triaged to PDS or neoadjuvant chemotherapy (NACT) followed by IDS using an institutional algorithm. Data on specific procedures performed, including consultants called, were collected from operative and pathology reports. Appropriate statistical analyses were applied.

Results: Overall, 467 patients underwent PDS and 434 underwent IDS; 76% (PDS) and 71% (IDS) of cases achieved complete gross resection. Comparing PDS vs IDS cohorts, median age was 63 years (range, 23-86) vs 67 years (range, 35-95), 79% vs 86% of patients had high-grade serous histology, and 38% vs 70% had stage IV disease. Most procedures (except ostomy, distal pancreatectomy) were more common during PDS (P < .05). Bowel surgery was performed during 65% of PDS and 33% of IDS, and upper abdominal surgery during 72% of PDS and 52% of IDS; both were more common during PDS (P < .001). Estimated blood loss (median, 500 mL [PDS] vs 300 mL [IDS]) and operative time (median, 362 min [PDS] vs 267 min [IDS]) were higher for PDS (P < .001). A consulting surgeon was utilized during 31% of PDS and 18% of IDS, with hepatopancreaticobiliary as the most commonly called service (61% and 65%, respectively).

Conclusions: In our study of patients with advanced-stage ovarian cancer, while most procedures were more often performed during PDS, NACT did not obviate the need for radical surgical resection. Thus, advanced surgical skills remain essential.

Keywords: Cytoreduction; Interval debulking surgery; Ovarian cancer; Primary debulking surgery; Radical surgery.

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Conflict of interest statement

Declaration of competing interest D. Chi reports personal fees from Apyx Medical, Verthermia Inc., Biom ‘Up, and AstraZeneca, as well as recent or current stock/options ownership of Apyx Medical, Verthemia, Intuitive Surgical, Inc., TransEnterix, Inc., Doximity, Moderna, and BioNTech SE. K. Long Roche reports travel support from Intuitive Surgical. The other authors do not have potential conflicts of interest to declare.

Figures

Figure 1.
Figure 1.. Frequency of Specific Procedures Performed at the Time of Primary Debulking Surgery (PDS) and Interval Debulking Surgery (IDS) for Patients Treated for Advanced-Stage Ovarian Cancer
*denotes statistical significance PDS – primary debulking surgery, IDS – interval debulking surgery, LN – lymph node
Figure 2.
Figure 2.. Rates of Bowel Resection and Upper Abdominal Procedures at the Time of Primary Debulking Surgery (PDS) and Interval Debulking Surgery (IDS)
*denotes statistical significance
See this image and copyright information in PMC

References

    1. Kehoe S, Hook J, Nankivell M, et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet. Jul 18 2015;386(9990):249–57. doi: 10.1016/s0140-6736(14)62223-6 - DOI - PubMed
    1. Vergote I, Tropé CG, Amant F, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. N Engl J Med. Sep 2 2010;363(10):943–53. doi: 10.1056/NEJMoa0908806 - DOI - PubMed
    1. Aletti GD, Dowdy SC, Podratz KC, Cliby WA. Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer. Am J Obstet Gynecol. Dec 2007;197(6):676.e1–7. doi: 10.1016/j.ajog.2007.10.495 - DOI - PubMed
    1. Straubhar AM, Filippova OT, Cowan RA, et al. A multimodality triage algorithm to improve cytoreductive outcomes in patients undergoing primary debulking surgery for advanced ovarian cancer: A Memorial Sloan Kettering Cancer Center team ovary initiative. Gynecol Oncol. Sep 2020;158(3):608–613. doi: 10.1016/j.ygyno.2020.05.041 - DOI - PMC - PubMed
    1. Suidan RS, Ramirez PT, Sarasohn DM, et al. A multicenter assessment of the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease at primary debulking for advanced epithelial ovarian cancer. Gynecol Oncol. Apr 2017;145(1):27–31. doi: 10.1016/j.ygyno.2017.02.020 - DOI - PMC - PubMed

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