M333 PROGNOSTIC IMPACT OF HISTOLOGICAL TYPE IN STAGE I EPITHELIAL OVARIAN CANCER BASED ON COMPREHENSIVE SURGICAL STAGING

ObjectivesThis study aimed to determine the incidence of lymph node (LN) metastases in presumed stage I-II low-grade epithelial ovarian cancer (EOC).MethodsEligible studies were identified from MEDLINE and EMBASE (time frame, 2015–1975), that analyzed patients with clinical or radiologic presumed early-stage EOC who underwent a complete pelvic and para-aortic lymphadenectomy as part of their surgical staging. The number and site of dissected and involved LNs and the correlation with overall outcome are analyzed. The termlow gradeand also the older termwell differentiatedwere used.ResultsThirteen of 978 identified studies were selected, and 13 of 75 studies were identified as eligible. A total of 1403 patients were analyzed in these 13 retrospective studies. The final International Federation of Gynecology and Obstetrics staging after completed surgical staging was I to II in 912 patients (65%). A total of 338 patients (24%) had grade 1 tumors whereas 473 patients (34%) had grade 2, and 502 patients (36%) had grade 3 tumors. Systematic lymphadenectomy was performed in 1159 patients (83%), whereof 1142 (82%) were pelvic and para-aortic LN dissections.In 185 patients (13%), an upstaging from an apparent clinical stage I-II to IIIC occurred because of LN involvement: 64 (35%) of the patients had only pelvic LNs metastases, 69 (37%) had only para-aortic LNs metastasis, and 51 (28%) had both a pelvic and para-aortic LN involvement. When analyzing only the patients with low-grade (grade 1 as the old classification) presumed early-stage disease (n = 273), only 8 patients (2.9%; range, 0–6.2) were identified with LNs metastases present.ConclusionsThe incidence of occult LN metastases in apparent early-stage low-grade EOC is 2.9% in a metaanalysis of retrospective studies. Future larger-scale prospectively assessed studies with established surgical quality of the LN dissection are warranted to establish the true incidence of LN metastasis in presumed early low-grade disease.

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Platinum-based chemotherapy of high-risk stage I epithelial ovarian cancer following comprehensive surgical staging

International Journal of Gynecology & Obstetrics ◽

10.1016/0020-7292(94)90161-9 ◽

1994 ◽

Vol 45 (2) ◽

pp. 202-202

Author(s):

S.C. Rubin ◽

G.Y.C. Wong ◽

J.P. Curtin ◽

R.R. Barakat ◽

T.B. Hakes ◽

...

Keyword(s):

Ovarian Cancer ◽

High Risk ◽

Epithelial Ovarian Cancer ◽

Stage I ◽

Surgical Staging ◽

Platinum Based Chemotherapy

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Benefit of adjuvant chemotherapy for stage I epithelial ovarian cancer according to the histologic type.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5552 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5552-5552

Author(s):

Hiroyuki Fujiwara ◽

Yuji Takei ◽

Yasushi Saga ◽

Shizuo Machida ◽

Naoto Sato ◽

...

Keyword(s):

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Recurrence Rate ◽

Histological Type ◽

Stage I ◽

Clear Cell Adenocarcinoma ◽

Observation Group ◽

Chemotherapy Group ◽

Stage Ia

5552 Background: The benefit of adjuvant chemotherapy in stage I epithelial ovarian cancer (EOC) remains controversial. We retrospectively examined stage I EOC patients to clarify the benefits of adjuvant chemotherapy according to the histological type. Methods: The outcomes of 131 patients with stage I EOC that was diagnosed by exact staging laparotomy at the Jichi Medical University Hospital over a 22-year period from 1988 to 2009 were evaluated. Eighty-seven of the patients had received adjuvant chemotherapy (stage: IA 17, IC(intraoperative rupture;R) 27, IC(other) 43; histological type: clear cell adenocarcinoma(CCC) 38, mucinous adenocarcinoma(MC) 18, endometrioid adenocarcinoma(EC) 18, serous adenocarcinoma(SAC) 13), while 44 had undergone observation alone (stage: IA 31, IC(R) 12, IC(other) 1; histological type: CCC 11, MC 17, EC 11 and SAC 5). Outcomes for patients were compared between the two groups. Results: The overall recurrence rate in the adjuvant chemotherapy group was 18.4% (16/87). The rates of recurrence according to stage were IA 5.9% (1/17), IC(R) 14.8% (4/27), and IC (other) 25.6% (11/43). Recurrence by histological type were CCC 12, SAC 2(G1and G2), and one each for EC and MC. Recurrence was seen in all stages in CCC patients; however, there was no recurrence in stage IA in patients with non-CCC. The overall recurrence rate in the observation group was 11.4% (5/44). All five recurrences occurred in CCC patients, and no recurrence was observed in the 33 non-CCC patients (IA 26, IC(R) 7). In patients with IC(R) CCC, the recurrence rate was significantly higher in the observation group (80%;4/5) than in the adjuvant chemotherapy group (18.8%; 3/16) (p = 0.025). Conclusions: This retrospective study showed that the CCC is associated with recurrence in stage I EOC and adjuvant chemotherapy for these patients may improve outcomes. The recommended states for adjuvant chemotherapy in stage I EOC are as follow: 1) all subtype of stage I for CCC, and 2) IC(other) for non-CCC. Although further prospective studies are required, these results afford useful information with which to determine the adjuvant chemotherapy in stage I EOC.

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Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer: a comparison of feasibility and safety

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2008.01190.x ◽

2008 ◽

Vol 18 (6) ◽

pp. 1202-1209 ◽

Cited By ~ 46

Author(s):

J.-Y. Park ◽

J. Bae ◽

M. C. Lim ◽

S. Y. Lim ◽

S.-S. Seo ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Prospective Trial ◽

Operating Time ◽

Stage I ◽

Surgical Staging ◽

Laparoscopic Staging ◽

Laparoscopy Group ◽

Estimated Blood Loss ◽

Laparotomy Group

The aim of this study was to compare laparoscopic and laparotomic surgical staging in patients with stage I epithelial ovarian cancer in terms of feasibility and safety. A retrospective chart review was undertaken of all patients with apparent stage I epithelial ovarian cancer who underwent laparoscopic (laparoscopy group) or laparotomic (laparotomy group) surgical staging at the Center for Uterine Cancer, National Cancer Center, Korea, between January 2001 and August 2006. During the study period, 19 patients underwent laparotomic surgical staging and 17 patients underwent laparoscopic surgical staging. No cases were converted from laparoscopy to laparotomy. The two groups were similar in terms of age, body mass index, procedures performed, number of lymph nodes retrieved, and operating time. The laparoscopy group had less estimated blood loss (P= 0.001), faster return of bowel movement (P< 0.001), and a shorter postoperative hospital stay (P= 0.002) compared to the laparotomy group. Transfusions were required only in two laparotomy patients, and postoperative complications occurred only in four laparotomy patients. However, two patients with stage IA grade 1 and 2 disease in laparoscopy group had recurrence with one patient dying of disease. The accuracy and adequacy of laparoscopic surgical staging were comparable to laparotomic approach, and the surgical outcomes were more favorable than laparotomic approach. However, the oncologic safety of laparoscopic staging was not certain. This is the first report on the possible hazards of laparoscopic staging in early-stage ovarian cancer. In the absence of a large prospective trial, this technique should be performed cautiously.

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PROGNOSTIC IMPACT OF THE TIME INTERVAL BETWEEN PRIMARY SURGERY AND CHEMOTHERAPY IN THE TREATMENT OF EPITHELIAL OVARIAN CANCER

10.26226/morressier.597eedbed462b80296ca151c ◽

2017 ◽

Author(s):

Fournier Marie

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Time Interval ◽

Prognostic Impact ◽

Primary Surgery

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Adjuvant oral alkylating chemotherapy in patients with stage I epithelial ovarian cancer

Cancer ◽

10.1002/1097-0142(19890315)63:6<1070::aid-cncr2820630605>3.0.co;2-f ◽

1989 ◽

Vol 63 (6) ◽

pp. 1070-1073 ◽

Cited By ~ 27

Author(s):

Holly H. Gallion ◽

John R. van Nagell ◽

Elvis S. Donaldson ◽

Robert V. Higgins ◽

Deborah E. Powell ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage I

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Comparison of Primary Tumor Size in Stage I and III Epithelial Ovarian Cancer

Anticancer Research ◽

10.21873/anticanres.13015 ◽

2018 ◽

Vol 38 (11) ◽

pp. 6507-6511 ◽

Cited By ~ 1

Author(s):

EDGAR PETRU ◽

CAROLA HUBER ◽

EVA SAMPL ◽

JOSEF HAAS

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Tumor Size ◽

Primary Tumor ◽

Stage I ◽

Primary Tumor Size

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Optimal Surgical Staging in Early Stage Epithelial Ovarian Cancer

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181e4a6eb ◽

2010 ◽

Vol 20 (7) ◽

pp. 1104

Author(s):

Ankit Jain ◽

Biswajit Dubashi ◽

Prakriti Jain

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Early Stage ◽

Surgical Staging

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Transcriptional Characterization of Stage I Epithelial Ovarian Cancer: A Multicentric Study

Cells ◽

10.3390/cells8121554 ◽

2019 ◽

Vol 8 (12) ◽

pp. 1554

Author(s):

Enrica Calura ◽

Matteo Ciciani ◽

Andrea Sambugaro ◽

Lara Paracchini ◽

Giuseppe Benvenuto ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Stage I ◽

Molecular Heterogeneity ◽

Low Grade ◽

Multicentric Study ◽

Molecular Alterations ◽

Molecular Features ◽

Signaling Axis ◽

Tumor Biopsies

Stage I epithelial ovarian cancer (EOC) represents about 10% of all EOCs. It is characterized by a complex histopathological and molecular heterogeneity, and it is composed of five main histological subtypes (mucinous, endometrioid, clear cell and high, and low grade serous), which have peculiar genetic, molecular, and clinical characteristics. As it occurs less frequently than advanced-stage EOC, its molecular features have not been thoroughly investigated. In this study, using in silico approaches and gene expression data, on a multicentric cohort composed of 208 snap-frozen tumor biopsies, we explored the subtype-specific molecular alterations that regulate tumor aggressiveness in stage I EOC. We found that single genes rather than pathways are responsible for histotype specificities and that a cAMP-PKA-CREB1 signaling axis seems to play a central role in histotype differentiation. Moreover, our results indicate that immune response seems to be, at least in part, involved in histotype differences, as a higher immune-reactive behavior of serous and mucinous samples was observed with respect to other histotypes.

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