Laparoscopic Assessment to Determine the Likelihood of Achieving Optimal Cytoreduction in Patients Undergoing Primary Debulking Surgery for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

Vaagn Andikyan, Annie Kim, Herbert F. Gretz, Konstantin Zakashansky, Monica Prasad-Hayes, Ann Marie Beddoe, Peter Dottino, John Mandeli, Linus Chuang

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: The objective of this study was to evaluate the safety and efficacy of laparoscopic assessment to determine the likelihood of achieving optimal cytoreduction (OC) in patients undergoing primary debulking surgery (PDS) for ovarian cancer. Methods: All patients who underwent diagnostic laparoscopy and PDS at our institution from January 2008 to December 2013 were identified. We determined the likelihood of achieving optimal cytoreduction by laparoscopic assessment based on tumor site, pattern of spread, and disease burden. Sensitivity was defined as the number of patients who achieved optimal cytoreduction after laparoscopic assessment divided by the number of patients with disease deemed resectable by laparoscopy. Results: We identified 55 patients during study period. Twenty-one of the 55 patients (38%) were early stage disease. Six (10.9%) patients had disease deemed unresectable and 49 (89.1%) had disease deemed resectable at the time of laparoscopy. OC was achieved in 48 of 49 (97.9%) patients. The sensitivity of laparoscopy in predicting OC was 98% (95% confidence interval, 89.3%-99.9%). The operation was completed laparoscopically in 23 of 49 patients (47%); in 26 of 49 (53%), PDS was performed by laparotomy. There were no port site metastases reported. The rate of postoperative complications was 16%. With a median follow-up of 30 months, the median overall survival was not reached and the 75th percentile for overall survival was 37 months. Conclusions: Laparoscopy was shown to have a high sensitivity in predicting OC and is a feasible tool in triaging patients with ovarian cancer. Laparoscopy is not associated with adverse surgical outcomes. ©

Original languageEnglish (US)
Pages (from-to)938-942
Number of pages5
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume41
Issue number10
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

Fingerprint

Fallopian Tubes
Laparoscopy
Neoplasms
Ovarian Neoplasms
Survival
Laparotomy
Confidence Intervals
Neoplasm Metastasis
Safety

Keywords

  • laparoscopy
  • optimal cytoreduction
  • ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Laparoscopic Assessment to Determine the Likelihood of Achieving Optimal Cytoreduction in Patients Undergoing Primary Debulking Surgery for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer. / Andikyan, Vaagn; Kim, Annie; Gretz, Herbert F.; Zakashansky, Konstantin; Prasad-Hayes, Monica; Beddoe, Ann Marie; Dottino, Peter; Mandeli, John; Chuang, Linus.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 41, No. 10, 01.10.2018, p. 938-942.

Research output: Contribution to journalArticle

Andikyan, Vaagn ; Kim, Annie ; Gretz, Herbert F. ; Zakashansky, Konstantin ; Prasad-Hayes, Monica ; Beddoe, Ann Marie ; Dottino, Peter ; Mandeli, John ; Chuang, Linus. / Laparoscopic Assessment to Determine the Likelihood of Achieving Optimal Cytoreduction in Patients Undergoing Primary Debulking Surgery for Ovarian, Fallopian Tube, or Primary Peritoneal Cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2018 ; Vol. 41, No. 10. pp. 938-942.
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abstract = "Objective: The objective of this study was to evaluate the safety and efficacy of laparoscopic assessment to determine the likelihood of achieving optimal cytoreduction (OC) in patients undergoing primary debulking surgery (PDS) for ovarian cancer. Methods: All patients who underwent diagnostic laparoscopy and PDS at our institution from January 2008 to December 2013 were identified. We determined the likelihood of achieving optimal cytoreduction by laparoscopic assessment based on tumor site, pattern of spread, and disease burden. Sensitivity was defined as the number of patients who achieved optimal cytoreduction after laparoscopic assessment divided by the number of patients with disease deemed resectable by laparoscopy. Results: We identified 55 patients during study period. Twenty-one of the 55 patients (38{\%}) were early stage disease. Six (10.9{\%}) patients had disease deemed unresectable and 49 (89.1{\%}) had disease deemed resectable at the time of laparoscopy. OC was achieved in 48 of 49 (97.9{\%}) patients. The sensitivity of laparoscopy in predicting OC was 98{\%} (95{\%} confidence interval, 89.3{\%}-99.9{\%}). The operation was completed laparoscopically in 23 of 49 patients (47{\%}); in 26 of 49 (53{\%}), PDS was performed by laparotomy. There were no port site metastases reported. The rate of postoperative complications was 16{\%}. With a median follow-up of 30 months, the median overall survival was not reached and the 75th percentile for overall survival was 37 months. Conclusions: Laparoscopy was shown to have a high sensitivity in predicting OC and is a feasible tool in triaging patients with ovarian cancer. Laparoscopy is not associated with adverse surgical outcomes. {\circledC}",
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AU - Andikyan, Vaagn

AU - Kim, Annie

AU - Gretz, Herbert F.

AU - Zakashansky, Konstantin

AU - Prasad-Hayes, Monica

AU - Beddoe, Ann Marie

AU - Dottino, Peter

AU - Mandeli, John

AU - Chuang, Linus

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N2 - Objective: The objective of this study was to evaluate the safety and efficacy of laparoscopic assessment to determine the likelihood of achieving optimal cytoreduction (OC) in patients undergoing primary debulking surgery (PDS) for ovarian cancer. Methods: All patients who underwent diagnostic laparoscopy and PDS at our institution from January 2008 to December 2013 were identified. We determined the likelihood of achieving optimal cytoreduction by laparoscopic assessment based on tumor site, pattern of spread, and disease burden. Sensitivity was defined as the number of patients who achieved optimal cytoreduction after laparoscopic assessment divided by the number of patients with disease deemed resectable by laparoscopy. Results: We identified 55 patients during study period. Twenty-one of the 55 patients (38%) were early stage disease. Six (10.9%) patients had disease deemed unresectable and 49 (89.1%) had disease deemed resectable at the time of laparoscopy. OC was achieved in 48 of 49 (97.9%) patients. The sensitivity of laparoscopy in predicting OC was 98% (95% confidence interval, 89.3%-99.9%). The operation was completed laparoscopically in 23 of 49 patients (47%); in 26 of 49 (53%), PDS was performed by laparotomy. There were no port site metastases reported. The rate of postoperative complications was 16%. With a median follow-up of 30 months, the median overall survival was not reached and the 75th percentile for overall survival was 37 months. Conclusions: Laparoscopy was shown to have a high sensitivity in predicting OC and is a feasible tool in triaging patients with ovarian cancer. Laparoscopy is not associated with adverse surgical outcomes. ©

AB - Objective: The objective of this study was to evaluate the safety and efficacy of laparoscopic assessment to determine the likelihood of achieving optimal cytoreduction (OC) in patients undergoing primary debulking surgery (PDS) for ovarian cancer. Methods: All patients who underwent diagnostic laparoscopy and PDS at our institution from January 2008 to December 2013 were identified. We determined the likelihood of achieving optimal cytoreduction by laparoscopic assessment based on tumor site, pattern of spread, and disease burden. Sensitivity was defined as the number of patients who achieved optimal cytoreduction after laparoscopic assessment divided by the number of patients with disease deemed resectable by laparoscopy. Results: We identified 55 patients during study period. Twenty-one of the 55 patients (38%) were early stage disease. Six (10.9%) patients had disease deemed unresectable and 49 (89.1%) had disease deemed resectable at the time of laparoscopy. OC was achieved in 48 of 49 (97.9%) patients. The sensitivity of laparoscopy in predicting OC was 98% (95% confidence interval, 89.3%-99.9%). The operation was completed laparoscopically in 23 of 49 patients (47%); in 26 of 49 (53%), PDS was performed by laparotomy. There were no port site metastases reported. The rate of postoperative complications was 16%. With a median follow-up of 30 months, the median overall survival was not reached and the 75th percentile for overall survival was 37 months. Conclusions: Laparoscopy was shown to have a high sensitivity in predicting OC and is a feasible tool in triaging patients with ovarian cancer. Laparoscopy is not associated with adverse surgical outcomes. ©

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