Surgical efficacy and quality of wide resection of the pelvic peritoneum in patients with epithelial ovarian cancer

Author:

Nishimura Akiho,Motohara Takeshi1ORCID,Morinaga Jun,Iwagoi Yutaka,Yamamoto Mayuko,Yamaguchi Munekage,Miyahara Yo,Tashiro Hironori,Katabuchi Hidetaka

Affiliation:

1. Kumamoto University: Kumamoto Daigaku

Abstract

Abstract Purpose The aim of study was to evaluate the impact of adding an extensive pelvic peritoneal stripping procedure, termed “wide resection of the pelvic peritoneum,” (WRPP) to standard surgery for epithelial ovarian cancer on survival effectiveness and to investigate the role of ovarian cancer stem cells (CSCs) in the pelvic peritoneum. Methods A total of 166 patients with ovarian cancer undergoing surgical treatment at Kumamoto University Hospital between 2002 and 2018 were retrospectively analyzed. Eligible patients were divided into three groups based on the surgical approach: standard surgery (SS) group (n = 36), WRPP group (standard surgery plus WRPP, n = 100), and rectosigmoidectomy (RS) group (standard surgery plus RS, n = 30). Survival outcomes were compared between the three groups. CD44 variant 6 (CD44v6) and EpCAM expression, as markers of ovarian CSCs, in peritoneal disseminated tumors were evaluated using immunofluorescence staining. Results With respect to patients with stage III–IV ovarian cancer, there were significant differences in overall and progression-free survival between the WRPP and SS groups, as revealed by univariate (hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.17–0.69; P = 0.003 and HR, 0.54; 95% CI, 0.31–0.95; P = 0.032, respectively) and multivariate Cox proportional hazards model (HR, 0.35; 95% CI, 0.17–0.70; P = 0.003 and HR, 0.54; 95% CI, 0.31–0.95; P = 0.032, respectively). Further, no significant differences were observed in survival outcomes between the RS group and the SS or WRPP group. Regarding the safety of WRPP, no significant differences in major intraoperative and postoperative complications were found between the three groups. Immunofluorescence analysis revealed a high percentage of CD44v6/EpCAM double-positive ovarian cancer cells in peritoneal disseminated tumors. Conclusion The present study demonstrates that WRPP significantly contributes to improved survival in patients with stage III–IV advanced ovarian cancer. WRPP could result in eradicating ovarian CSCs and disrupting the CSC niche microenvironment in the pelvic peritoneum.

Publisher

Research Square Platform LLC

Reference37 articles.

1. The hallmarks of ovarian cancer stem cells and niches: Exploring their harmonious interplay in therapy resistance;Motohara T;Semin Cancer Biol,2021

2. Updates and New Options in Advanced Epithelial Ovarian Cancer Treatment;Kurnit KC;Obstet Gynecol,2021

3. Pathophysiological dynamics of human ovarian surface epithelial cells in epithelial ovarian carcinogenesis;Okamura H;Int Rev Cytol,2005

4. Epithelial ovarian cancer;Lheureux S;The Lancet,2019

5. Surgical resection of tumor bulk in the primary treatment of ovarian carcinoma;Griffiths CT;Natl Cancer Inst Monogr,1975

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3