Abstract
Background and ObjectivesThe aim of this study was to determine whether peritoneal washing cytology (PWC) during interval debulking surgery (IDS) could predict the prognosis of patients with pelvic high‐grade serous carcinoma (HGSC) achieving R0 status.MethodsBetween January 2007 and May 2018, 110 patients with ovarian/tubal/primary peritoneal HGSC received platinum‐based neo‐adjuvant chemotherapy, followed by IDS at National Cancer Center Hospital, Japan. All the patients achieved R0 debulking status, defined as no macroscopic residual tumor in the peritoneal cavity at the completion of IDS. PWC was performed before debulking during IDS. The survival outcomes were compared between the PWC‐positive and PWC‐negative groups.ResultsThe median progression free survival (PFS) for the entire cohort was 17 months (range, 5‐133 months). The median PFS for the PWC‐positive group was significantly shorter than that of the PWC‐negative group (16 vs 19 months, HR 2.04, 95% CI 1.22‐3.41, P‐value < 0.01). Increased risk of progression was observed on both univariate and multivariate analyses, including age and FIGO stage (HR 2.28; 95% CI 1.35‐3.84, P < 0.01).ConclusionsThe positive PWC during IDS was found to predict earlier disease recurrence in patients with pelvic HGSC achieving R0 status. As performing PWC during IDS becomes standard practice, prospective validation should be conducted in the future.
Highlights
Ovarian cancer is the eighth most common cause of cancer‐related deaths in women worldwide.[1]
This study revealed that positive peritoneal washing cytology (PWC) during interval debulking surgery (IDS) had worse prognostic impact on patients with pelvic high‐grade serous carcinoma (HGSC) without macroscopic residual tumor
A few previous studies have reported on the prognostic impact of PWC during IDS in patients with ovarian cancer
Summary
Ovarian cancer is the eighth most common cause of cancer‐related deaths in women worldwide.[1]. Peritoneal washing cytology (PWC) is a sensitive indicator of ovarian surface involvement and peritoneal dissemination by ovarian tumors.[9,10] PWC is not a novel technique; it is simple, less invasive, inexpensive, and globally accepted It may identify subclinical, microscopic peritoneal spread and provide valuable staging and prognostic information for chemo‐naïve ovarian cancer patients.[11] the clinical utility of PWC has not been established for patients undergoing IDS, a higher risk of recurrence would be predicted for patients with positive PWC during IDS, reflecting microscopic residual disease. The aim of this retrospective study was to determine whether PWC during IDS could help predict the prognosis of patients with pelvic HGSC achieving R0 status
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