A Laparoscopic Adjusted Model Able to Predict the Risk of Intraoperative Capsule Rupture in Early-stage Ovarian Cancer : Laparoscopic Ovarian Cancer Spillage Score (LOChneSS Study)
Copyright © 2022 AAGL. Published by Elsevier Inc. All rights reserved..
STUDY OBJECTIVE: To identify preoperative/intraoperative patient and tumor characteristics associated with an increased risk of tumor spillage during minimally invasive surgery (MIS) for early-stage ovarian cancer (OC). The secondary end point was to develop a score system able to estimate the risk of tumor rupture during MIS.
DESIGN: Retrospective observational study.
SETTING: Patients with International Federation of Gynecology and Obstetrics stage I OC.
PATIENTS: Patients aged ≥18 years old, with International Federation of Gynecology and Obstetrics stage IA to IC1 OC of any histology.
INTERVENTIONS: Preoperative and intraoperative characteristics of patients treated with MIS for early-stage OC at Policlinico Universitario Agostino Gemelli, IRCCS in Rome, Italy, from January 1, 2001, to December 31, 2017, were collected.
MEASUREMENTS AND MAIN RESULTS: A total of 151 patients were included. Previous pelvic surgery was more represented in patients with nonruptured tumors (46.0% vs 63.4%; p = .042). In addition, a larger tumor diameter (p <.001), a higher body mass index (p = .032), ultrasound characteristics (p = .029), and adhesions to large bowel (14% vs 2.0%; p = .003), uterus (44% vs 6.9%; p <.001), contralateral ovary (8.0% vs 0%; p = .004), ovarian fossa (64% vs 14.9%; p <.001), and pouch of Douglas peritoneum (32% vs 4.0%; p <.001) increased rupture rate. At multivariate analysis, a larger tumor diameter (p <.001) and adhesions to ovarian fossa peritoneum (p = .007) were independently associated with intraoperative cancer spillage and included in the score calculation. A disease-free survival (DFS) difference between the rupture group and the no-rupture group was detected (5-year DFS, 74.9% vs 94.4%; p = .011), with superimposable overall survival (5-year overall survival, 91.2% vs 97.9%; p = .089).
CONCLUSION: Some preoperative/intraoperative characteristics increase the risk of tumor rupture during MIS for early-stage OC. A laparoscopic predictive model of capsule disruption could be considered to intraoperatively tailor surgical approach to prevent tumor spillage and avoid affecting patient's DFS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Journal of minimally invasive gynecology - 29(2022), 8 vom: 15. Aug., Seite 961-967 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ghirardi, Valentina [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 15.08.2022 Date Revised 05.09.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jmig.2022.04.014 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM340295082 |
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| 100 | 1 | |a Ghirardi, Valentina |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Laparoscopic Adjusted Model Able to Predict the Risk of Intraoperative Capsule Rupture in Early-stage Ovarian Cancer |b Laparoscopic Ovarian Cancer Spillage Score (LOChneSS Study) |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 15.08.2022 | ||
| 500 | |a Date Revised 05.09.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 AAGL. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a STUDY OBJECTIVE: To identify preoperative/intraoperative patient and tumor characteristics associated with an increased risk of tumor spillage during minimally invasive surgery (MIS) for early-stage ovarian cancer (OC). The secondary end point was to develop a score system able to estimate the risk of tumor rupture during MIS | ||
| 520 | |a DESIGN: Retrospective observational study | ||
| 520 | |a SETTING: Patients with International Federation of Gynecology and Obstetrics stage I OC | ||
| 520 | |a PATIENTS: Patients aged ≥18 years old, with International Federation of Gynecology and Obstetrics stage IA to IC1 OC of any histology | ||
| 520 | |a INTERVENTIONS: Preoperative and intraoperative characteristics of patients treated with MIS for early-stage OC at Policlinico Universitario Agostino Gemelli, IRCCS in Rome, Italy, from January 1, 2001, to December 31, 2017, were collected | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: A total of 151 patients were included. Previous pelvic surgery was more represented in patients with nonruptured tumors (46.0% vs 63.4%; p = .042). In addition, a larger tumor diameter (p <.001), a higher body mass index (p = .032), ultrasound characteristics (p = .029), and adhesions to large bowel (14% vs 2.0%; p = .003), uterus (44% vs 6.9%; p <.001), contralateral ovary (8.0% vs 0%; p = .004), ovarian fossa (64% vs 14.9%; p <.001), and pouch of Douglas peritoneum (32% vs 4.0%; p <.001) increased rupture rate. At multivariate analysis, a larger tumor diameter (p <.001) and adhesions to ovarian fossa peritoneum (p = .007) were independently associated with intraoperative cancer spillage and included in the score calculation. A disease-free survival (DFS) difference between the rupture group and the no-rupture group was detected (5-year DFS, 74.9% vs 94.4%; p = .011), with superimposable overall survival (5-year overall survival, 91.2% vs 97.9%; p = .089) | ||
| 520 | |a CONCLUSION: Some preoperative/intraoperative characteristics increase the risk of tumor rupture during MIS for early-stage OC. A laparoscopic predictive model of capsule disruption could be considered to intraoperatively tailor surgical approach to prevent tumor spillage and avoid affecting patient's DFS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Ovarian cancer | |
| 650 | 4 | |a Spillage | |
| 650 | 4 | |a Survival | |
| 700 | 1 | |a De Felice, Francesca |e verfasserin |4 aut | |
| 700 | 1 | |a Rosati, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Ergasti, Raffaella |e verfasserin |4 aut | |
| 700 | 1 | |a Gueli Alletti, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Mascilini, Floriana |e verfasserin |4 aut | |
| 700 | 1 | |a Scambia, Giovanni |e verfasserin |4 aut | |
| 700 | 1 | |a Fagotti, Anna |e verfasserin |4 aut | |
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