| Positive thoracoscopy | Negative thoracoscopy | |
|---|---|---|
| ||
| n (%) | 27 (36.0) | 48 (64.0) |
| Median (range) age, years | 60.5 (29–75) | 63 (39–76) |
| GOG Performance Status (0,1) | 100% | 100% |
| Location of largest disease | ||
| Diaphragm | 2/27 (7.4%) | 1/48 (2.1%) |
| Omentum | 7/27 (25.9%) | 10/48 (20.8%) |
| Pelvis | 15/27 (55.6%) | 37/48 (77.1%) |
| Lymph nodes | 2/27 (7.4%) | 1/48 (2.1%) |
| Mesentery | 2/27 (7.4%) | 1/48 (2.1%) |
Table 2. Surgical Procedures
Conclusions
Epithelial
ovarian cancer is most commonly diagnosed in advanced stages. The
prognostic value of complete cytoreduction has been reported and
confirmed in several publications.6,21,22
Similarly intraperitoneal chemotherapy is associated with improved
overall survival in women with small-volume residual disease (<1 cm)
and, as with cytoreductive surgery, carries with it increased morbidity.
It is therefore mandatory to do all that is necessary to identify disease that cannot be resected before undertaking a maximal cytoreductive effort for disease that will not benefit from the use of intraperitoneal chemotherapy.
Using the surgical approach described allows both of these goals to be met, thereby maximising the potential benefit to women with advanced-stage epithelial ovarian cancer.
It is therefore mandatory to do all that is necessary to identify disease that cannot be resected before undertaking a maximal cytoreductive effort for disease that will not benefit from the use of intraperitoneal chemotherapy.
Using the surgical approach described allows both of these goals to be met, thereby maximising the potential benefit to women with advanced-stage epithelial ovarian cancer.
