title: Positive peritoneal cytology at interval surgery is a poor prognostic factor in patients with stage T3c advanced ovarian carcinoma: A retrospective study.
abstract: OBJECTIVE
  The purpose of our study is to investigate clinically significant prognostic factors at the time of interval surgery (IS), comprising interval look surgery and interval debulking surgery, for T3c (International Federation of Gynecology and Obstetrics stage IIIc to IV) advanced ovarian cancer (AOC) patients during primary treatment.
  
  
  METHODS
  We reviewed records of patients with T3c AOC who underwent IS following neoadjuvant chemotherapy or up-front primary debulking surgery with adjuvant chemotherapy at our institution between January 1996 and December 2010. For analysis of prognostic factors, cytology of peritoneal exfoliative cells at IS was added to clinicopathological variables.
  
  
  RESULTS
  A retrospective analysis was performed on 50 cases. The median age was 61.1 years (range, 38-78), with median follow-up of 45.9 months (range, 12-122). Macroscopic tumors were completely resected in 32 cases (64%) at IS. Univariate analyses of clinicopathological factors for IS identified preoperative serum cancer antigen-125 levels (≥20 IU/mL; P = 0.0539), number of residual lesions at IS (≥20; P = 0.0554), incomplete surgery at IS (P = 0.0171) and positive peritoneal cytology at IS (P = 0.0015) as significant factors for prognosis regarding progression-free survival (PFS). Multivariate analysis identified positive peritoneal cytology (P = 0.0303) as a unique independent predictor of poor prognosis in PFS.
  
  
  CONCLUSIONS
  Positive peritoneal cytology at IS appears to be a significant factor for poor prognosis in PFS, which may provide useful information for post-IS chemotherapy planning. IS in the treatment of AOC may be useful for not only complete resection, but also for identification of patients with poor prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nagasaka
authors.forename: Kei
authors.initials: K
authors.lastname: Kawana
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tomio
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Tsuruga
authors.forename: Mayuyo
authors.initials: M
authors.lastname: Mori-Uchino
authors.forename: Shiho
authors.initials: S
authors.lastname: Miura
authors.forename: Michihiro
authors.initials: M
authors.lastname: Tanikawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Kenbun
authors.initials: K
authors.lastname: Sone
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Adachi
authors.forename: Yoko
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Takahide
authors.initials: T
authors.lastname: Arimoto
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Oda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D010537:Peritoneum / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies
keywords: interval surgery; ovarian cancer; peritoneal cytology; prognostic factor