Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted?

J. N. Barlin, K. C. Long, E. J. Tanner, G. J. Gardner, M. M. Leitao, D. A. Levine, Y. Sonoda, N. R. Abu-Rustum, R. R. Barakat, D. S. Chi

Research output: Contribution to journalArticle

Abstract

Objectives To determine if extensive upper abdominal surgery (UAS) affected overall survival (OS) in patients left with ≤ 1 cm but visible residual disease after undergoing primary cytoreductive surgery for ovarian cancer. Our secondary objective was to determine if leaving ≤ 1 cm but visible residual throughout the small bowel (SB) conferred a worse prognosis. Methods All stage IIIB-IV ovarian cancer patients who had visible but ≤ 1 cm residual disease at time of primary cytoreductive surgery from 2001 to 2010 were identified. Extensive UAS procedures and residual SB involvement were recorded. Results The 219 patients identified with ≤ 1 cm but visible residual disease had a median OS of 51 months. In this cohort, 127 had extensive UAS performed, and 87 had residual disease involving the SB. Univariate OS analysis was performed. There was no significant difference in OS between patients who did or did not have extensive UAS (45 vs. 52 months, P = 0.56), or between patients with or without residual SB disease (45 vs. 51 months, P = 0.84). Factors that were significantly associated with OS were age, ASA score, family history, and stage. Conclusions Patients cytoreduced to ≤ 1 cm but visible residual disease who required UAS did not have a worse OS than those who did not require UAS. OS was similar if residual disease involved the SB or not. For ovarian cancer patients with disease not amenable to complete gross resection, extensive surgery should still be considered to achieve ≤ 1 cm but visible residual disease status, including cases where the residual disease involves the SB.

Original languageEnglish (US)
Pages (from-to)284-288
Number of pages5
JournalGynecologic Oncology
Volume130
Issue number2
DOIs
StatePublished - Aug 2013
Externally publishedYes

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Survival
Ovarian Neoplasms
Survival Analysis

Keywords

  • Ovarian cancer Overall survival Extensive surgery Small bowel

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Barlin, J. N., Long, K. C., Tanner, E. J., Gardner, G. J., Leitao, M. M., Levine, D. A., ... Chi, D. S. (2013). Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted? Gynecologic Oncology, 130(2), 284-288. https://doi.org/10.1016/j.ygyno.2013.05.006

Optimal (≤ 1 cm) but visible residual disease : Is extensive debulking warranted? / Barlin, J. N.; Long, K. C.; Tanner, E. J.; Gardner, G. J.; Leitao, M. M.; Levine, D. A.; Sonoda, Y.; Abu-Rustum, N. R.; Barakat, R. R.; Chi, D. S.

In: Gynecologic Oncology, Vol. 130, No. 2, 08.2013, p. 284-288.

Research output: Contribution to journalArticle

Barlin, JN, Long, KC, Tanner, EJ, Gardner, GJ, Leitao, MM, Levine, DA, Sonoda, Y, Abu-Rustum, NR, Barakat, RR & Chi, DS 2013, 'Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted?', Gynecologic Oncology, vol. 130, no. 2, pp. 284-288. https://doi.org/10.1016/j.ygyno.2013.05.006
Barlin JN, Long KC, Tanner EJ, Gardner GJ, Leitao MM, Levine DA et al. Optimal (≤ 1 cm) but visible residual disease: Is extensive debulking warranted? Gynecologic Oncology. 2013 Aug;130(2):284-288. https://doi.org/10.1016/j.ygyno.2013.05.006
Barlin, J. N. ; Long, K. C. ; Tanner, E. J. ; Gardner, G. J. ; Leitao, M. M. ; Levine, D. A. ; Sonoda, Y. ; Abu-Rustum, N. R. ; Barakat, R. R. ; Chi, D. S. / Optimal (≤ 1 cm) but visible residual disease : Is extensive debulking warranted?. In: Gynecologic Oncology. 2013 ; Vol. 130, No. 2. pp. 284-288.
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abstract = "Objectives To determine if extensive upper abdominal surgery (UAS) affected overall survival (OS) in patients left with ≤ 1 cm but visible residual disease after undergoing primary cytoreductive surgery for ovarian cancer. Our secondary objective was to determine if leaving ≤ 1 cm but visible residual throughout the small bowel (SB) conferred a worse prognosis. Methods All stage IIIB-IV ovarian cancer patients who had visible but ≤ 1 cm residual disease at time of primary cytoreductive surgery from 2001 to 2010 were identified. Extensive UAS procedures and residual SB involvement were recorded. Results The 219 patients identified with ≤ 1 cm but visible residual disease had a median OS of 51 months. In this cohort, 127 had extensive UAS performed, and 87 had residual disease involving the SB. Univariate OS analysis was performed. There was no significant difference in OS between patients who did or did not have extensive UAS (45 vs. 52 months, P = 0.56), or between patients with or without residual SB disease (45 vs. 51 months, P = 0.84). Factors that were significantly associated with OS were age, ASA score, family history, and stage. Conclusions Patients cytoreduced to ≤ 1 cm but visible residual disease who required UAS did not have a worse OS than those who did not require UAS. OS was similar if residual disease involved the SB or not. For ovarian cancer patients with disease not amenable to complete gross resection, extensive surgery should still be considered to achieve ≤ 1 cm but visible residual disease status, including cases where the residual disease involves the SB.",
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AU - Tanner, E. J.

AU - Gardner, G. J.

AU - Leitao, M. M.

AU - Levine, D. A.

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AU - Abu-Rustum, N. R.

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N2 - Objectives To determine if extensive upper abdominal surgery (UAS) affected overall survival (OS) in patients left with ≤ 1 cm but visible residual disease after undergoing primary cytoreductive surgery for ovarian cancer. Our secondary objective was to determine if leaving ≤ 1 cm but visible residual throughout the small bowel (SB) conferred a worse prognosis. Methods All stage IIIB-IV ovarian cancer patients who had visible but ≤ 1 cm residual disease at time of primary cytoreductive surgery from 2001 to 2010 were identified. Extensive UAS procedures and residual SB involvement were recorded. Results The 219 patients identified with ≤ 1 cm but visible residual disease had a median OS of 51 months. In this cohort, 127 had extensive UAS performed, and 87 had residual disease involving the SB. Univariate OS analysis was performed. There was no significant difference in OS between patients who did or did not have extensive UAS (45 vs. 52 months, P = 0.56), or between patients with or without residual SB disease (45 vs. 51 months, P = 0.84). Factors that were significantly associated with OS were age, ASA score, family history, and stage. Conclusions Patients cytoreduced to ≤ 1 cm but visible residual disease who required UAS did not have a worse OS than those who did not require UAS. OS was similar if residual disease involved the SB or not. For ovarian cancer patients with disease not amenable to complete gross resection, extensive surgery should still be considered to achieve ≤ 1 cm but visible residual disease status, including cases where the residual disease involves the SB.

AB - Objectives To determine if extensive upper abdominal surgery (UAS) affected overall survival (OS) in patients left with ≤ 1 cm but visible residual disease after undergoing primary cytoreductive surgery for ovarian cancer. Our secondary objective was to determine if leaving ≤ 1 cm but visible residual throughout the small bowel (SB) conferred a worse prognosis. Methods All stage IIIB-IV ovarian cancer patients who had visible but ≤ 1 cm residual disease at time of primary cytoreductive surgery from 2001 to 2010 were identified. Extensive UAS procedures and residual SB involvement were recorded. Results The 219 patients identified with ≤ 1 cm but visible residual disease had a median OS of 51 months. In this cohort, 127 had extensive UAS performed, and 87 had residual disease involving the SB. Univariate OS analysis was performed. There was no significant difference in OS between patients who did or did not have extensive UAS (45 vs. 52 months, P = 0.56), or between patients with or without residual SB disease (45 vs. 51 months, P = 0.84). Factors that were significantly associated with OS were age, ASA score, family history, and stage. Conclusions Patients cytoreduced to ≤ 1 cm but visible residual disease who required UAS did not have a worse OS than those who did not require UAS. OS was similar if residual disease involved the SB or not. For ovarian cancer patients with disease not amenable to complete gross resection, extensive surgery should still be considered to achieve ≤ 1 cm but visible residual disease status, including cases where the residual disease involves the SB.

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