paywalled - Video-assisted thoracic surgery (VATS) evaluation of intrathoracic disease in patients with FIGO III and IV stage ovarian cancer

Gynecologic Oncology - Video-assisted thoracic surgery (VATS) evaluation of intrathoracic disease in patients with FIGO III and IV stage ovarian cancer

Purchase

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Abstract

Introduction

The aim of this study was to assess the influence of video-assisted thoracic surgery (VATS) on our treatment decisions in FIGO III and IV ovarian cancer patients.

Highlights

► Preoperative chest CTs is not an appropritate staging tool for the evaluation of intrathoracic tumorload in advanced Ovarian Cancer patients
► Video-assisted thoracic surgery can be performed quickly and safely before deciding about primary cytoreduction or neodadjuvant chemotherapy in advanced Ovarian Cancer patients

JAMA: Effect of an Indwelling Pleural Catheter vs Chest Tube and Talc Pleurodesis for Relieving Dyspnea in Patients With Malignant Pleural EffusionThe TIME2 Randomized Controlled TrialIndwelling Pleural Catheters vs Talc Pleurodesis

 Effect of an Indwelling Pleural Catheter vs Chest Tube and Talc Pleurodesis for Relieving Dyspnea in Patients With Malignant Pleural EffusionThe TIME2 Randomized Controlled Trial Indwelling Pleural Catheters vs Talc Pleurodesis

paywalled: Clinical implications of pleural effusions in ovarian cancer - Porcel - Respirology - Wiley Online Library

 Blogger's Note: note the use of neoadjuvant therapy in this particular subset of ovarian cancer patients

Clinical implications of pleural effusions in ovarian cancer - Porcel - Respirology

Keywords:

• malignant pleural effusion;
• ovarian cancer;
• thoracoscopy;
• pleurodesis

ABSTRACT

The pleural cavity constitutes the most frequent extra-abdominal metastatic site in ovarian carcinoma (OC). In patients with OC and pleural effusions, a positive fluid cytology is required for a stage IV diagnosis. Unfortunately, about 30% of malignant pleural effusions exhibit false negative cytological pleural fluid results. In those circumstances, exploratory video-assisted thoracoscopic surgery (VATS) serves as a diagnostic, staging and even therapeutic modality. Maximal (no visible disease) or, at least, optimal (no residual implant greater than 1 cm) cytoreduction should be the primary surgical goal in stage IV OC patients. This is due to residual tumor after cytoreductive surgery being one of the most important factors impacting on survival. Although malignant pleural effusions do not preclude abdominal surgical debulking, excision of gross pleural nodules may be necessary to achieve optimal cytoreduction. VATS quantifies pleural tumor burden and allows for intrathoracic cytoreduction or, if the latter is not feasible, ensures that abdominal surgery is not unnecessarily performed on women in whom gross tumor would still remain in the pleural space afterwards. Taxane-platinum neoadjuvant chemotherapy should be offered to this group. Patients with tumor extension into the pleural space have a median overall survival of 2 years.