Ovarian Carcinoma - A Single Centre Case-Series Descriptive Analysis of Surgical Procedures.

IF 0.8 Q4 SURGERY
Chirurgia Pub Date : 2024-09-01 DOI:10.21614/chirurgia.3023
George Daniel Subtirelu, Andreea Steriu, Eugen Bratucu
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引用次数: 0

Abstract

Background: Ovarian surface epithelial cancer (OSEC) are an entity in which, according to genomics and pathology data accumulated in the last couple of decades, several different nosological entities with distinct etiologies are aggregated. In ovarian cancer, surgery is the pivot of treatment, to which medical oncological treatment is added by recommendation in most cases. Material and Methods: This is a single centre sample of 263 cases with OSEC operated from January 2014 until December 2021 with a 28-month period of follow-up, until 30th April 2024. OSEC surgical procedures in stages IIB to III and IV of the disease are complex interventions in order to have the R0/optimal cytoreduction achieved, so we summarised and coded them as follows: 1 = biopsy (of the tumour/peritoneum); 2 = bilateral/unilateral adnexectomy (BA/UA) total hysterectomy (TH) omentectomy +- peritoneal biopsies; 3 = (2) with total hysterectomy with bilateral adnexectomy (THBA) +- by extraperitoneal/subperitoneal route+peritonectomies (exclusively diaphragmatic) and electrocauterization of peritoneal carcinomatous lesions; 4 = (3) with visceral (multiple) resections +- stoma; 5 = (4) with diaphragmatic peritonectomies/stripping/partial resection of the diaphragm; 6 = palliative surgery. Results: Debulking surgery (DS) was carried out for n = 182 patients with no residual tissue = R0 being registered in n = 41. Results for patients with residual tissue (n = 141) after DS recorded the following findings: 1 cm (49% cases), 1.1-2 cm (29%) and 2 cm (22%). Recorded results for endometrial ovarian carcinoma (EC) n = 27 shown a tumour free survival probability estimate (%) at 60 months of 66% as both surgery and platinum based chemotherapy are efficient. For clear cell ovarian carcinoma (CCC) n = 7 recorded results shown a tumour free estimate (%) at 60 months of 14%, being known the controversy as to whether or not paclitaxel is an active drug for CCC. Major complications were recorded in 25 patients with a fatality ratio of 5/25. Conclusion: Considering OSEC is a relatively rare disease and the importance of collecting substantial numbers of samples by histotypes to further knowledge about ovarian cancer it comes crucial to establish collaborative endeavour of tertiary centers with standardised and quality control strategies.

卵巢癌--单中心手术病例系列描述性分析。
背景:卵巢表面上皮癌(OSEC)是一个实体,根据过去几十年积累的基因组学和病理学数据,它聚集了几种不同病因的不同命名实体。对于卵巢癌,手术是治疗的关键,在大多数情况下,建议在手术的基础上增加肿瘤内科治疗。材料和方法:这是自2014年1月至2021年12月对263例卵巢癌手术病例进行的单中心抽样调查,随访28个月,直至2024年4月30日。OSEC在疾病的IIB、III和IV期的手术过程是复杂的干预措施,以实现R0/最佳细胞减灭术,因此我们将其总结并编码如下:1 =(肿瘤/腹膜)活检;2 = 双侧/单侧附件切除术(BA/UA)全子宫切除术(TH)网膜切除术 +- 腹膜活检;3 = (2)全子宫切除术+双侧附件切除术(THBA)+- 通过腹膜外/腹膜下途径+腹膜切除术(仅膈肌)和腹膜癌灶电灼术;4 = (3)内脏(多处)切除+-造口;5 = (4)膈肌腹膜切除/膈肌截断/部分切除;6 = 姑息性手术。结果对 n = 182 例患者进行了切除手术(DS),其中 n = 41 例患者无残留组织 = R0。有残留组织的患者(n = 141)在切除手术后的结果如下:1厘米(49%)、1.1-2厘米(29%)和2厘米(22%)。子宫内膜卵巢癌(EC)n = 27 的记录结果显示,由于手术和铂类化疗均有效,60 个月的无瘤生存概率估计值(%)为 66%。透明细胞卵巢癌(CCC)n = 7 的记录结果显示,60 个月无瘤生存概率(%)为 14%,众所周知,紫杉醇是否是治疗 CCC 的有效药物还存在争议。25名患者出现了主要并发症,死亡率为5/25。结论考虑到卵巢癌是一种相对罕见的疾病,以及按组织类型收集大量样本对进一步了解卵巢癌的重要性,建立具有标准化和质量控制策略的三级中心合作至关重要。
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来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
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