Laparoscopic restaging of borderline ovarian tumours (BLOT): a retrospective study of 142 cases
| Autor: | G. Ferrarrese, Anne-Sophie Azuar, G. Mage, Jacques Dauplat, Michel Canis, Nicolas Bourdel |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
medicine.medical_specialty Population Disease-Free Survival Gynecologic Surgical Procedures medicine Humans Ovarian tumours education Laparoscopy Aged Neoplasm Staging Retrospective Studies Radical treatment Aged 80 and over Ovarian Neoplasms education.field_of_study medicine.diagnostic_test business.industry Incidence (epidemiology) Obstetrics and Gynecology Retrospective cohort study Middle Aged University hospital Prognosis Surgery Blot Reproductive Medicine Female business |
| Zdroj: | European journal of obstetrics, gynecology, and reproductive biology. 168(1) |
| ISSN: | 1872-7654 |
| Popis: | Objectives Primary objective: To analyse the impact of restaging, on recurrences and survival, in BLOT. Secondary objective: To cluster patients who could be exempted from restaging. Study design This retrospective study, included patients operated for a BLOT, between January 1990, and December 2007, in gynaecological surgery units of the University Hospital of Clermont-Ferrand. Two groups were evaluated: patients with and without optimal restaging. Results One hundred and forty-two patients were included. Optimal initial staging rate was 38.7% ( n =55). Among the eighty-seven women not initially staged, two groups were compared: restaged ( n =45) and non-restaged patients ( n =42). Mean follow-up was 80.5 months. Overall survival was 93.7%. Relapse rate was 7.7% ( n =11). Disease free survival (DFS) was 88% after a mean follow-up of 80.5 months. One death was noted. Optimal restaging rate was 31.7% ( n =45, 43 by laparoscopy). Mean follow-up was of 87.1 months among restaged patients, 84.5 months among non-restaged patients ( p =0.93). Relapse incidence was significantly higher in non restaged, than in restaged patients ( p =0.008). DFS was significantly longer among restaged than non-restaged patients, ( p =0.072). Younger age ( p =0.04), conservative treatment ( p −4 ) or non-diploidy ( p =0.04) increased the incidence of relapse. Conclusions When initial staging is missing, restaging improves the patients outcome in comparison to non-restaged groups. Laparoscopy is a valuable surgical option. This study suggests that a selected group of patients, older than 30 years old, submitted to a radical treatment, presenting a diploid, non micropapillar, mucinous BLOT, without visible implants during careful peritoneal inspection, could be exempted from restaging. They represented 11.6% of our population. |
| Databáze: | OpenAIRE |
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