Evaluation of preoperative predictors of optimal cytoreductive surgery in women with epithelial ovarian cancer
Predictors of optimal cytoreductive surgery in EOC
DOI:
https://doi.org/10.3329/bmrcb.v47i3.59993Keywords:
Epithelial ovarian cancer, CT scan, Cytoreductive surgery, CA-125Abstract
Background: Globally, among gynaecologic cancers, ovarian cancer represents higher morbidity and mortality. Approximately, 90% of ovarian cancer are epithelial in origin. Primary cytoreductive surgery followed by chemotherapy is the cornerstone of treatment for epithelial ovarian cancer. Suboptimal cytoreduction may result in surgical complications and delay in chemotherapy which are against survival. Therefore, it is important to predict patients who are unlikely to achieve optimum cytoreduction.
Objectives: To evaluate the preoperative clinical, laboratory and radiographic parameters to predict feasibility of optimum cytoreduction in advanced stage epithelial ovarian cancer.
Methods: This prospective observational study was conducted at the department of gynaecological oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka between January 2020 to December 2020. Thirty-one malignant epithelial ovarian cancer cases were enrolled through purposive sampling. Clinical history, physical examination, preoperative CA 125 and total platelet count were noted. CT scan based on FIGO staging 2014 was compared to the surgical staging. Maximum surgical effort for cytoreduction was achieved and the risk factors for sub-optimal cytoreduction were identified.
Results: Optimal cytoreduction was achieved in 64.5% cases. There was difference between optimal and suboptimal cytoreduction regarding CA125 and total platelet count (TPC) (p = <0.05). In CT scan, there was difference too, regarding liver involvement (p =0.048), peritoneum (p =0.024), hydroureter (p =0.003) and lymphadenopathy (p =0.000). Multivariate logistic regression analysis showed that peritoneal involvement (OR= 13.500, 95% CI (1.340-135.983)) in CT scan, significantly increase the risk of suboptimal cytoreduction.
Conclusion: Preoperative CA125 >500U/ml and total platelet count >450×109/L and peritoneal involvement, liver involvement, lymphadenopathy and hydroureter in preoperative CT scan are important predictor of suboptimal cytoreduction.
Bangladesh Med Res Counc Bull 2021; 47(3): 280-288
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Copyright (c) 2022 Sheikh Farhana Huda, Fawzia Hossain, Muhammad Jasim Uddin, Kaniz Farhana, Shah Md Mahfuzur Rahman
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