Hepatobiliary Disease Resection in Patients with Advanced Epithelial Ovarian Cancer: Prognostic Role and Optimal Cytoreduction
- Resource Type
- Authors
- Violante Di Donato; Michele Carlo Schiavi; Ottavia D’Oria; Anna Di Pinto; Giorgia Perniola; Ludovico Muzii; Francesco Battaglia; Pasquale Berloco; Andrea Giannini; Margherita Fischetti; Pierluigi Benedetti Panici; Francesca Lecce
- Source
- Annals of Surgical Oncology
- Subject
- Peritoneal Surface Malignancy
medicine.medical_specialty
Digestive System Diseases
Carcinoma, Ovarian Epithelial
Metastasis
03 medical and health sciences
0302 clinical medicine
Cytoreduction Surgical Procedures
Carcinoma
Medicine
Humans
030212 general & internal medicine
cytoreduction
ovarian cancer
hepato-biliary metastasis
perioperative complications
Retrospective Studies
Porta hepatis
Ovarian Neoplasms
business.industry
Hepatobiliary disease
Retrospective cohort study
Perioperative
medicine.disease
Prognosis
Surgery
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
business
Ovarian cancer
- Language
- English
- ISSN
- 1534-4681
1068-9265
Objective The purpose of this study was to evaluate the feasibility and safety in terms of prognostic significance and perioperative morbidity and mortality of cytoreduction in patients affected by advance ovarian cancer and hepato-biliary metastasis. Methods Patients with a least one hepatobiliary metastasis who have undergone surgical treatment with curative intent of were considered for the study. Perioperative complications were evaluated and graded with Accordion severity Classification. Five-year PFS and OS were estimated using the Kaplan–Meier curve. Results Sixty-seven (20.9%) patients had at least one metastasis to the liver, biliary tract, or porta hepatis. Forty-four (65.7%) and 23 (34.3%) patients underwent respectively high and intermediate complexity surgery according. Complete cytoreduction was achieved in 48 (71.6%) patients with hepato-biliary disease. In two patients (2.9%) severe complications related to hepatobiliary surgery were reported. The median PFS for the patients with hepato-biliary involvement (RT = 0 vs. RT > 0) was 19 months [95% confidence interval (CI) 16.2–21.8] and 8 months (95% CI 6.1–9.9). The median OS for the patients with hepato-biliary involvement (RT = 0 vs. RT > 0) 45 months (95% CI 21.2–68.8 months) and 23 months (95% CI 13.9–32.03). Conclusions Hepatobiliary involvement is often associated with high tumor load and could require high complex multivisceral surgery. In selected patients complete cytoreduction could offer survival benefits. Morbidity related to hepatobiliary procedures is acceptable. Careful evaluation of patients and multidisciplinary approach in referral centers is mandatory.