title: Porta hepatis peritonectomy and hepato-celiac lymphadenectomy in patients with stage IIIC-IV ovarian cancer: Diagnostic pathway, surgical technique and outcomes.
abstract: To report the surgical technique of ovarian cancer resection at the porta hepatis (PH) and hepato-celiac lymph nodes (HCL). To assess surgical and survival outcomes. Define the accuracy of an integrated diagnostic pathway.
  
  
  
  Patients with FIGO stage IIIC-IV ovarian cancer that underwent Visceral-Peritoneal Debulking (VPD). Data of patients with disease at the PH/HCL during VPD were extracted from our database. The CT scan findings were compared with the exploratory laparoscopy. Accuracy of CT scan, intra- and post-operative morbidity, rate of complete resection (CR), disease free and overall survival are reported.
  
  
  
  Thirty one patients out of 216 (14.3%) had tumor at the PH and/or HCL. In 8 patients out of 31 (25.8%) it was only found with the aid of the exploratory laparoscopy. CR was achieved in 28 patients out of 31 (90.3%). Pathology confirmed disease in the PH/HCL specimens of all but one patient. Overall morbidity relating to the VPD was 29.2%. No complication was specifically related to the PH/HCL. Median disease free survival was 19months and median overall survival was 42months.
  
  
  
  PH/HCL surgery was required in 15% of patients with FIGO stage IIIC-IV. The surgery was feasible, safe and significantly contributed to CR. CT scan failed to identify the disease in 31% of the patients. CT and laparoscopy correctly identified all patients.
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK. Electronic address: roberto.tozzi@obs-gyn.ox.ac.uk.
authors: Roberto
authors: R
authors: Tozzi
authors: Department of Radiology, Oxford University Hospital, Oxford, UK.
authors: Zoe
authors: Z
authors: Traill
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Riccardo
authors: R
authors: Garruto Campanile
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Federico
authors: F
authors: Ferrari
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Hooman
authors: H
authors: Soleymani Majd
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Joost
authors: J
authors: Nieuwstad
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Kieran
authors: K
authors: Hardern
authors: Department of Gynaecologic Oncology, Oxford University Hospital, Oxford, UK.
authors: Kumar
authors: K
authors: Gubbala
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Hepato-celiac lymphadenectomy; Ovarian cancer; Porta hepatis