Impact of liver cirrhosis due to chronic hepatitis C viral infection on the outcome of ovarian cancer: a prospective study.
BACKGROUND
This study was designed to investigate the impact of liver cirrhosis due to chronic hepatitis C virus (HCV) infection on the disease-free and overall survival of ovarian cancer patients undergoing a standard primary operation followed by standard chemotherapy. Attainment of the operative goals, intra- and postoperative events, possible complications under chemotherapy necessitating the termination of treatment, and the impact of ovarian cancer treatment on liver function were assessed.


METHODS
This was a prospective observational study that included only patients with primary epithelial ovarian cancer. Only patients with Child-Turcotte-Pugh classification class A disease were recruited. Patients were divided into two groups according to whether they had liver cirrhosis. All the patients underwent primary debulking surgery followed by 6 cycles of chemotherapy, and were followed-up for 24 months after chemotherapy was completed.


RESULTS
We recruited 77 patients, 19 of whom had liver cirrhosis. There were no significant differences between patients with or without liver cirrhosis with respect to tumor stage, histopathological type, tumor grade, or optimal operative debulking. There was no registered liver dysfunction-related mortality in the follow-up period, and there were no statistically significant differences between the groups with respect to disease-free or overall survival (p = 0.719 and p = 0.524, respectively).


CONCLUSIONS
From the results of this study, we conclude that compensated liver cirrhosis (Child-Turcotte-Pugh class A) due to chronic HCV infection affects neither the disease-free nor the overall survival of ovarian cancer patients, regardless of their stage. This study shows that it is possible to treat ovarian cancer patients with cirrhosis caused by HCV infection the same as any other patient; treatment does not have to be adjusted as long as the patients have Class A disease.
Department of Surgical Oncology, Oncology Center Mansura University, University of Mansura, Mansura, Egypt. dr.basel@hotmail.com.
Basel
B
Refky
Department of Surgical Oncology, Oncology Center Mansura University, University of Mansura, Mansura, Egypt. sherifkotb60@yahoo.com.
Sherif
S
Kotb
Department of Surgical Oncology, Oncology Center Mansura University, University of Mansura, Mansura, Egypt. tamerfadysurg@gmail.com.
Tamer
T
Fady
Transplant Center, Cleveland Clinic, Digestive Disease Institute, Cleveland, OH, USA. drahmedmarwan@gmail.com.
Ahmad
A
Marwan
Department of Public Health and Preventive Medicine, University of Mansura, Mansura, Egypt. dr_doaashokry@hotmail.com.
Doaa
D
Abd El-Khalek
Department of Surgical Oncology, Oncology Center Mansura University, University of Mansura, Mansura, Egypt. waleedelnahas@yahoo.com.
Waleed
W
Elnahas
Department of Surgical Oncology, Oncology Center Mansura University, University of Mansura, Mansura, Egypt. mthafez@yahoo.com.
Mohamed T
MT
Hafez
Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Germany. eduard.malik@klinikum-oldenburg.de.
Eduard
E
Malik
Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Rahel-Straus-Straße 10, 26133, Oldenburg, Germany. amr.soliman@uni-oldenburg.de.|Department of Obstetrics and Gynecology, University of Alexandria, Alexandria, Egypt. amr.soliman@uni-oldenburg.de.
Amr A
AA
Soliman
D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications* / Q000209:etiology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D010051:Ovarian Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D063868:Patient Outcome Assessment; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome