Liver Resection as Part of Cytoreductive Surgery for Ovarian Cancer.

Jorge Luna-Abanto,Vladimir Villoslada Terrones,Manuel Álvarez Larraondo,Luis García Ruiz,Jheff Laura Martinez

doi:10.1089/gyn.2019.0074

Abstract

Objective: The aim of this study was to describe and evaluate the safety of hepatic resections for ovarian cancer liver metastases and the benefit in terms of survival as part of cytoreductive surgery among peritoneal seeding and parenchymal metastases.Materials and Methods: Data were reviewed retrospectively from patients who underwent liver resection as part of cytoreductive surgery for ovarian cancer at the Instituto Nacional de Enfermedades Neoplásicas, in Lima, Perú, from January 2009 to December 2017.Results: From January 2009 to December 2017, 1211 patients underwent surgical cytoreduction for ovarian cancer; 39 of these patients had liver resection as part of their surgical treatment, with 9, 17, and 13 patients receiving primary, secondary, and tertiary, resections, respectively. The mean age of the patients was 46, the majority (87%) had stage III/IV ovarian cancer. In addition, 21 patients had parenchymal metastasis resections, and 95% of the patients had Dindo–Clavien I and II grade complications. The 30-day mortality rate was 0.Conclusions: Liver resection for advanced ovarian cancer is a safe procedure for primary up to quaternary cytoreduction and may confer survival benefits to patients.

Highlights

Ovarian cancer is the leading cause of death from gynecologic malignancies worldwide, with an estimated incidence of 22 000 new cases and 14 000 deaths in the United States during 2013.1 In Peru, according to the Metropolitan Lima cancer registry 2004–2005, ovarian cancer is the eighth most-frequent neoplasm and the second mostfrequent gynecologic neoplasm after cervical cancer, representing the second most-frequent cause of death.[2]
It is known that patients with advanced ovarian cancer, regardless of the site of metastasis have poor prognoses.[3]
Data were retrospectively reviewed from patients who underwent surgical cytoreduction for ovarian cancer that included liver resection at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru) from January 2009 to December 2017

Summary

Introduction

Ovarian cancer is the leading cause of death from gynecologic malignancies worldwide, with an estimated incidence of 22 000 new cases and 14 000 deaths in the United States during 2013.1 In Peru, according to the Metropolitan Lima cancer registry 2004–2005, ovarian cancer is the eighth most-frequent neoplasm and the second mostfrequent gynecologic neoplasm after cervical cancer, representing the second most-frequent cause of death.[2] Most patients are diagnosed at advanced stages, as no effective screening tests exist and symptoms are discreet.[1,2] Ovarian cancer can spread through the intraperitoneal, lymphatic, and hematogenous routes. The most common sites of metastatic disease are the peritoneum, liver, and lymph nodes. It is known that patients with advanced ovarian cancer, regardless of the site of metastasis have poor prognoses.[3] Winter et al

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Results

Discussion

Conclusion