What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study

Bunja J Rungruang; Austin Miller; Thomas C Krivak; Neil S Horowitz; Noah Rodriguez; Chad A Hamilton; Floor J Backes; Linda F Carson; Michael Friedlander; David G Mutch; Michael J Goodheart; Krishnansu S Tewari; Robert M Wenham; Michael A Bookman; G Larry Maxwell; Scott D Richard

doi:10.1002/cncr.30414

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What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study

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What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study

Bunja J Rungruang, Austin Miller, Thomas C Krivak, Neil S Horowitz, Noah Rodriguez, Chad A Hamilton, Floor J Backes, Linda F Carson, Michael Friedlander, David G Mutch, …

Cancer, Vol.123(6), pp.985-993

05/15/2017

DOI: 10.1002/cncr.30414

PMCID: PMC5339038

PMID: 27864921

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Abstract

The purpose of this study was to determine the effect of retroperitoneal (RP) exploration on progression-free survival (PFS) and overall survival (OS) in epithelial ovarian cancer (EOC) patients with stage IIIC disease who underwent optimal debulking surgery. Data were collected from records of the Gynecologic Oncology Group 182 (GOG-182) study of stage IIIC EOC patients cytoreduced to no gross residual disease (R0) or minimal gross residual (<1 cm) disease (MGRD) at primary surgery. Patients with stage IIIC disease by intraperitoneal (IP) tumor were included and divided into 3 groups: 1) > 2 cm IP tumor without lymph node involvement (IP/RP-), 2) > 2 cm IP tumor with lymph node involvement (IP/RP+), and 3) > 2 cm IP tumor with no RP exploration (IP/RP?). The effects of disease distribution and RP exploration on PFS and OS were assessed using Kaplan-Meier and proportional hazards methods. There were 1871 stage IIIC patients in GOG-182 who underwent optimal primary debulking surgery. Of these, 689 (36.8%) underwent RP exploration with removal of lymph nodes from at least 1 para-aortic site, and 1182 (63.2%) did not. There were 269 patients in the IP/RP- group, 420 patients in the IP/RP + group, and 1182 patients in the IP/RP? group. Improved PFS (18.5 vs 16.0 months; P < .0001) and OS (53.3 vs 42.8 months; P < .0001) were associated with RP exploration versus no exploration. Patients with MGRD had improved PFS (16.8 vs 15.1 months, P = 0.0108) and OS (44.9 vs 40.5 months, P = 0.0076) versus no exploration. RP exploration at the time of primary surgery in patients with optimally debulked stage IIIC EOC is associated with a survival benefit. Cancer 2017;123:985-93. © 2016 American Cancer Society.

Neoplasms, Glandular and Epithelial - pathology

Lymph Nodes - pathology

Humans

Middle Aged

Retroperitoneal Space - surgery

Ovarian Neoplasms - pathology

Treatment Outcome

Ovarian Neoplasms - mortality

Cytoreduction Surgical Procedures

Neoplasms, Glandular and Epithelial - surgery

Neoplasm Metastasis

Neoplasm Grading

Neoplasms, Glandular and Epithelial - mortality

Survival Analysis

Aged, 80 and over

Carcinoma, Ovarian Epithelial

Adult

Female

Aged

Neoplasm Staging

Odds Ratio

Ovarian Neoplasms - surgery

Details

Title: Subtitle: What is the role of retroperitoneal exploration in optimally debulked stage IIIC epithelial ovarian cancer? An NRG Oncology/Gynecologic Oncology Group ancillary data study
Creators: Bunja J Rungruang - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Georgia of Augusta University, Augusta, Georgia
Austin Miller - Gynecologic Oncology Group, Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, New York
Thomas C Krivak - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Western Pennsylvania Allegheny Hospital, Pittsburgh, Pennsylvania
Neil S Horowitz - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Boston, Massachusetts
Noah Rodriguez - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Kaiser Permanente Irvine Medical Center, Irvine, California
Chad A Hamilton - Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland
Floor J Backes - Division of Gynecologic Oncology, Department Obstetrics and Gynecology, Ohio State University Medical Center, Columbus, Ohio
Linda F Carson - Department of OB/GYN and Women's Health, University of Minnesota School of Medicine, Minneapolis, Minnesota
Michael Friedlander - Department of Cancer Medicine, ANZGOG, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
David G Mutch - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, Missouri
Michael J Goodheart - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa
Krishnansu S Tewari - Department of Obstetrics and Gynecology, University of California Medical Center-Irvine, Orange, California
Robert M Wenham - Department of Gynecology Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
Michael A Bookman - Medical Oncology, Arizona Oncology, Tuscon, Arizona
G Larry Maxwell - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Inova Fairfax Hospital Women's Center, Falls Church, Virginia
Scott D Richard - Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania
Resource Type: Journal article
Publication Details: Cancer, Vol.123(6), pp.985-993
DOI: 10.1002/cncr.30414
PMID: 27864921
PMCID: PMC5339038
NLM abbreviation: Cancer
ISSN: 0008-543X
eISSN: 1097-0142
Publisher: United States
Grant note: U10 CA180868 / NCI NIH HHS U10 CA180822 / NCI NIH HHS U10 CA027469 / NCI NIH HHS UL1 TR001414 / NCATS NIH HHS U10 CA180833 / NCI NIH HHS U10 CA037517 / NCI NIH HHS P30 CA086862 / NCI NIH HHS
Language: English
Date published: 05/15/2017
Academic Unit: Obstetrics and Gynecology
Record Identifier: 9983930273102771

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