Optimal cytoreduction: is a CT's picture worth a surgeon's word?

Autores de IIS La Fe

• Luis Javier Matute Tobias

  Autor

• Santiago Domingo Del Pozo

  Autor

Participantes ajenos a IIS La Fe

• Trelis Blanes, Alexandra
• Lago Leal, Victor
• Padilla Iserte, Pablo
• Perez Martinez, Rosario
• Belloch Ripolles, Vicente
• Gurrea, Marta
• Cardenas Rebollo, Jose Miguel

Grupos

• Medicina Fetal y Reproductiva

Abstract

INTRODUCTION: The presence of residual disease after cytoreductive surgery is subjectively determined by the surgeon at the end of the operation. Nevertheless, in up to 21-49% of CT scans, residual disease can be found. The aim of this study was to establish the relationship between post-surgical CT findings after optimal cytoreduction in patients with advanced ovarian cancer and oncological outcome. MATERIAL AND METHODS: Patients with advanced ovarian cancer (FIGO II and IV), diagnosed between 2007 and 2019 in Hospital La Fe Valencia, in whom cytoreductive surgery was performed, achieving R0 or R1, were assessed for eligibility (n = 440). A total of 323 patients were excluded because a post-operative CT scan was not performed between the third and eighth post-surgery week and prior to the start of chemotherapy. RESULTS: 117 patients were finally included. The CT findings were classified into three categories: no evidence, suspicious or conclusive of residual tumour/progressive disease. 29.9% of CT scans were "conclusive of residual tumour/progressive disease". No differences were found when the DFS (p = 0.158) and OS (p = 0.215) of the three groups were compared (p = 0.158). CONCLUSION: After cytoreduction in ovarian cancer with no macroscopic disease or residual tumour < 1 cm result, up to 29.9% of post-operative CT scans before chemotherapy found measurable residual or progressive disease. Notwithstanding, a worse DFS or OS was not associated with this group of patients.

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Keywords

• Advanced ovarian cancer; CT scan; Optimal cytoreduction; Prognosis; Residual disease