Results of surgical treatment for isolated recurrent ovarian cancer involving the liver
Keywords:Recurrence, Ovarian Cancer, Surgical Treatment, Liver
Summary. Objective: to investigate the effectiveness and factors that can influence on surgical treatment of isolated recurrent ovarian cancer involving the liver.
Materials and methods: A retrospective analysis of medical documentation of ovarian cancer patients, who underwent surgical removal of the recurrent tumors localized in the liver, performed in State Establishment «Zaitsev V.T. Institute of General and Emergency Surgery of the Academy of Medical Sciences of Ukraine» from January 2001 to December 2010 (n = 29).
Results. Overall survival increased significantly while disease-free interval (DFI) increase (after primary cytoreduction) and optimal secondary cytoreduction is achieved. Median overall survival for DFI <12 months was 13 months, 12-24 months – 41 months, > 24 months – 61 months (p <0,05). Performance of optimal secondary cytoreduction leads to increase of overall survival from 10 to 44 months (p <0,05). Median overall survival after secondary surgery was 41 months (95% CI; 6-62 months), median DFI – 26 months (95% CI; 3-42 months); 5-year survival rate was 37%. Serum CA-125, tumor size and number of lesions did not correlate with survival rates.
Conclusions. Recurrent ovarian cancer involving the liver should not be regarded solely as a result of hematogenous dissemination. Taking into account the biological characteristics of ovarian cancer, it can be the result of implantation spread of disease. Liver resection – aggressive, but effective, safe and affordable intervention. Indications should be individualized for patients with recurrent ovarian cancer.
Abood, G., Bowen, M., Potkul, R., Aranha, G., & Shoup, M. (2008) Hepatic resection for recurrent metastatic ovarian cancer. Am. J. Surg., 195, 370–373. doi: 10.1016/j.amjsurg.2007.12.012.
Chi, D. S., McCaughty, K., Diaz, J. P., Huh, J., Schwabenbauer, S., Hummer, A. J., et al. (2006) Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma. Cancer, 106, 1933–1939.
Harrison, L. E., Brennan, M.F, Newman, E., Fortner, J. G., Picardo, A., Blumgart, L. H., & Fong, Y. (1997) Hepatic resection for noncolorectal, nonneuroendocrine metastases: a fifteen-year experience with ninety-six patients. Surgery, 121, 625–32. doi:10.1016/S0039-6060(97)90050-7.
Harter, P., du Bois, A., Hahmann, M., Hasenburg, A., Burges, A., Loibl, S., et al. (2006) Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Ann. Surg. Oncol., 13, 1702–1710. doi: 10.1245/s10434-006-9058-0.
Kolev, V., Pereira, E. B., Schwartz, M., Sarpel, U., Roayaie, S., Labow, D., et al. (2014) The role of liver resection at the time of secondary cytoreduction in patients with recurrent ovarian cancer. Int. J. Gynecol. Cancer., 24(1), 70–74. doi: 10.1097/IGC.0000000000000026.
Laurent, C., Rullier, E., Feyler, A., Masson, B., & Saric, J. (2001) Resection of noncolorectal and nonneuroendocrine liver metastases: late metastases are the only chance of cure. World J. Surg., 25, 1532–6.
Logmans, A., ten Kate, M., & Van Lent, M. (2000) Metastasectomy, a feasible treatment in selected cases with gynecologic malignancy. Eur. J. Obstet. Gynecol. Reprod. Biol., 91, 165–7. doi: http://dx.doi.org/10.1016/S0301-2115(99)00236-5.
Merideth, M. A., Cliby, W. A., Keeney, G. L., Lesnick, T. G., Nagorney, D. M., & Podratz, K. C. (2003) Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol. Oncol., 89, 16–21.
Niu, G., Shen, C., Cui, W., & Li, Q. (2012) Hepatic resection is safe for metachronous hepatic metastases from ovarian cancer. Cancer Biol. Med., 9, 182–187. doi: 10.7497/j.issn.2095-3941.2012.03.005.
Pekmezci, S., Saribeyoglu, K., Aytac, E., Arvas, M., Demirkiran, F., & Ozguroglu, M. (2010) Surgery for isolated liver metastasis of ovarian cancer. Asian J. Surg., 33(2), 83–88. doi: 10.1016/S1015-9584(10)60014-0.
Roh, H. J., Kim, D. Y., Joo, W. D., Yoo, H. J., Kim, J. H., Kim, Y. M., et al. (2011) Hepatic resection as part of secondary cytoreductive surgery for recurrent ovarian cancer involving the liver. Arch. Gynecol. Obstet., 284(5), 1223–1229. doi: 10.1007/s00404-010-1750-4.
Rose, P. G., Piver, M. S., Tsukada, Y., & Lau, T. S. (1989) Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. Cancer., 64, 1508–1513.
Weitz, J., Blumgart, L. H., Fong, Y., Jarnagin, W. R., D'Angelica, M., Harrison, L. E., & DeMatteo, R. P. (2005) Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann. Surg., 241, 269–276. doi: 10.1097/01.sla.0000150244.72285.ad.
Zang, R. Y., Harter, P., Chi, D. S., Sehouli, J., Jiang, R., Tropé, C. G., et al. (2011) Predictors of survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery based on the pooled analysis of an international collaborative cohort. Br. J. Cancer., 105, 890–896. doi: 10.1038/bjc.2011.328.
How to Cite
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)