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
To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer. 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 prospectivel...
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| Veröffentlicht in: | Gynecologic oncology 2024-08, Vol.187, p.80-84 |
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| creator | Filippova, Olga T. Boecking, Katherine Broach, Vance Gardner, Ginger J. Sonoda, Yukio Chi, Dennis S. Zivanovic, Oliver Long Roche, Kara |
| description | To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer.
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.
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 |
| doi_str_mv | 10.1016/j.ygyno.2024.05.009 |
| format | Article |
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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.
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).
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.
•Complete gross resection was achieved at the time of primary or interval debulking surgery in >70% of patients•Most advanced surgical procedures were more common during primary than interval debulking surgery•Bowel and upper abdominal surgery were performed often during both primary and interval debulking surgery•Neoadjuvant chemotherapy did not obviate need for radical surgical resection; advanced surgical skills remain essential</description><identifier>ISSN: 0090-8258</identifier><identifier>ISSN: 1095-6859</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2024.05.009</identifier><identifier>PMID: 38735143</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Ovarian Epithelial - drug therapy ; Carcinoma, Ovarian Epithelial - pathology ; Carcinoma, Ovarian Epithelial - surgery ; Chemotherapy, Adjuvant - statistics & numerical data ; Cytoreduction ; Cytoreduction Surgical Procedures - methods ; Cytoreduction Surgical Procedures - statistics & numerical data ; Female ; Humans ; Interval debulking surgery ; Middle Aged ; Neoadjuvant Therapy - statistics & numerical data ; Neoplasm Staging ; Ovarian cancer ; Ovarian Neoplasms - drug therapy ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - surgery ; Primary debulking surgery ; Radical surgery ; Young Adult</subject><ispartof>Gynecologic oncology, 2024-08, Vol.187, p.80-84</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c309t-7474f6b856afc52aba5377352c9dfaf6178d253008346a3eda10c9b2b6c73be93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ygyno.2024.05.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38735143$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Filippova, Olga T.</creatorcontrib><creatorcontrib>Boecking, Katherine</creatorcontrib><creatorcontrib>Broach, Vance</creatorcontrib><creatorcontrib>Gardner, Ginger J.</creatorcontrib><creatorcontrib>Sonoda, Yukio</creatorcontrib><creatorcontrib>Chi, Dennis S.</creatorcontrib><creatorcontrib>Zivanovic, Oliver</creatorcontrib><creatorcontrib>Long Roche, Kara</creatorcontrib><title>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</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer.
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.
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).
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.
•Complete gross resection was achieved at the time of primary or interval debulking surgery in >70% of patients•Most advanced surgical procedures were more common during primary than interval debulking surgery•Bowel and upper abdominal surgery were performed often during both primary and interval debulking surgery•Neoadjuvant chemotherapy did not obviate need for radical surgical resection; advanced surgical skills remain essential</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Ovarian Epithelial - drug therapy</subject><subject>Carcinoma, Ovarian Epithelial - pathology</subject><subject>Carcinoma, Ovarian Epithelial - surgery</subject><subject>Chemotherapy, Adjuvant - statistics & numerical data</subject><subject>Cytoreduction</subject><subject>Cytoreduction Surgical Procedures - methods</subject><subject>Cytoreduction Surgical Procedures - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Interval debulking surgery</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - statistics & numerical data</subject><subject>Neoplasm Staging</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - drug therapy</subject><subject>Ovarian Neoplasms - pathology</subject><subject>Ovarian Neoplasms - surgery</subject><subject>Primary debulking surgery</subject><subject>Radical surgery</subject><subject>Young Adult</subject><issn>0090-8258</issn><issn>1095-6859</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EokPhCZDQXbJJ6sRxfpAQqkb8VBR1wbC2HPtm8ODEg-2MlPfjwXA6LUtWlqxzvmOfQ8jrguYFLeqrQ77sl8nlJS2rnPKc0u4J2RS041nd8u4p2aQbmrUlby_IixAOlFJGi_I5uWBtw3hRsQ35s_M46QBmgnBEZQaj4OidQj17DHBEPzg_ogYZIf5EiGZEcAOoJTqfRCoaN0HSgDtJb-QESk4K_Tu4WaER_Ula0NjP9peZ9hBmv0e_QPSzXcBiCOClNkraD3AN33B0CWLhu3UJ9RVjAqy27T0UtrgSYYdyhLuUt0CIs15ekmeDtAFfPZyX5Menj7vtl-z27vPN9vo2U4x2MWuqphrqvuW1HBQvZS85a1IRper0IIe6aFpdckZpy6paMtSyoKrry75WDeuxY5fk7ZmbGvo9Y4hiNEGhtXJCNwfBKK8qVrUlS1J2lirvQvA4iKM3Y3qxKKhY5xMHcT-fWOcTlIs0VnK9eQiY-1T6P8_jXknw_izA9M2TQS-CMpi60cajikI789-Av3kosWw</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Filippova, Olga T.</creator><creator>Boecking, Katherine</creator><creator>Broach, Vance</creator><creator>Gardner, Ginger J.</creator><creator>Sonoda, Yukio</creator><creator>Chi, Dennis S.</creator><creator>Zivanovic, Oliver</creator><creator>Long Roche, Kara</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202408</creationdate><title>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</title><author>Filippova, Olga T. ; Boecking, Katherine ; Broach, Vance ; Gardner, Ginger J. ; Sonoda, Yukio ; Chi, Dennis S. ; Zivanovic, Oliver ; Long Roche, Kara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c309t-7474f6b856afc52aba5377352c9dfaf6178d253008346a3eda10c9b2b6c73be93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Ovarian Epithelial - drug therapy</topic><topic>Carcinoma, Ovarian Epithelial - pathology</topic><topic>Carcinoma, Ovarian Epithelial - surgery</topic><topic>Chemotherapy, Adjuvant - statistics & numerical data</topic><topic>Cytoreduction</topic><topic>Cytoreduction Surgical Procedures - methods</topic><topic>Cytoreduction Surgical Procedures - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Interval debulking surgery</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - statistics & numerical data</topic><topic>Neoplasm Staging</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - drug therapy</topic><topic>Ovarian Neoplasms - pathology</topic><topic>Ovarian Neoplasms - surgery</topic><topic>Primary debulking surgery</topic><topic>Radical surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Filippova, Olga T.</creatorcontrib><creatorcontrib>Boecking, Katherine</creatorcontrib><creatorcontrib>Broach, Vance</creatorcontrib><creatorcontrib>Gardner, Ginger J.</creatorcontrib><creatorcontrib>Sonoda, Yukio</creatorcontrib><creatorcontrib>Chi, Dennis S.</creatorcontrib><creatorcontrib>Zivanovic, Oliver</creatorcontrib><creatorcontrib>Long Roche, Kara</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Filippova, Olga T.</au><au>Boecking, Katherine</au><au>Broach, Vance</au><au>Gardner, Ginger J.</au><au>Sonoda, Yukio</au><au>Chi, Dennis S.</au><au>Zivanovic, Oliver</au><au>Long Roche, Kara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2024-08</date><risdate>2024</risdate><volume>187</volume><spage>80</spage><epage>84</epage><pages>80-84</pages><issn>0090-8258</issn><issn>1095-6859</issn><eissn>1095-6859</eissn><abstract>To evaluate procedures performed during primary debulking surgery (PDS) and interval debulking surgery (IDS) for ovarian cancer.
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.
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).
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.
•Complete gross resection was achieved at the time of primary or interval debulking surgery in >70% of patients•Most advanced surgical procedures were more common during primary than interval debulking surgery•Bowel and upper abdominal surgery were performed often during both primary and interval debulking surgery•Neoadjuvant chemotherapy did not obviate need for radical surgical resection; advanced surgical skills remain essential</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38735143</pmid><doi>10.1016/j.ygyno.2024.05.009</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged Aged, 80 and over Carcinoma, Ovarian Epithelial - drug therapy Carcinoma, Ovarian Epithelial - pathology Carcinoma, Ovarian Epithelial - surgery Chemotherapy, Adjuvant - statistics & numerical data Cytoreduction Cytoreduction Surgical Procedures - methods Cytoreduction Surgical Procedures - statistics & numerical data Female Humans Interval debulking surgery Middle Aged Neoadjuvant Therapy - statistics & numerical data Neoplasm Staging Ovarian cancer Ovarian Neoplasms - drug therapy Ovarian Neoplasms - pathology Ovarian Neoplasms - surgery Primary debulking surgery Radical surgery Young Adult |
| title | 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 |
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