International Surveys Focus on Surgical Practice Patterns in Advanced Ovarian Cancer
Posted: Tuesday, January 15, 2019
Defining optimal cytoreduction as no visible tumor may be increasingly important in advanced ovarian cancer, and aggressive surgery beyond conventional gynecologic surgery may be required, according to a study of international survey studies on surgical practice patterns for advanced ovarian cancer. In addition, the preference of neoadjuvant chemotherapy and the positive expectation of preoperative determination of optimal cytoreduction tended to be higher in Europe than in the United States. Professor Hee Seung Kim, of the Seoul National University of Medicine, Republic of Korea, and colleagues, published their findings in the Japanese Journal of Clinical Oncology.
The researchers analyzed 8 survey studies from the United States, the Czech Republic, South Africa, Australia, the United Kingdom, and Belgium, 6 of which were conducted since 2010. Based on these studies, Professor Kim and colleagues extracted 18 questions, classified as comprehensive and procedure information.
Regarding the definition of optimal cytoreduction, 48% of the studies preferred < 1 cm, whereas 30% preferred no visible tumor. In the studies after 2010, 44% preferred no visible tumor as the definition. Intraoperative findings precluding optimal cytoreduction included confluent diaphragm disease, omental disease involving the spleen or pancreas, disease involving the base of the mesentery, and bulky para-aortic lymph nodes, with omental disease involving the spleen or pancreas becoming a more important indicator in the studies since 2010.
More than 50% of upper abdominal or urologic surgeries tended to be conducted by other surgeons. Although the preference for neoadjuvant chemotherapy was relatively low, with 57% of studies reporting use in 1% to 10% of patients, European studies showed a higher preference than U.S. studies.
Disclosure: The study authors reported no conflicts of interest.