Skip to main content

Advertisement

SpringerLink
Log in

Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer

  • Review – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Surgical cytoreduction remains a cornerstone in the management of patients with advanced and recurrent epithelial ovarian cancer. Parenchymal liver metastases determine stage VI disease and are commonly considered a major limit in the achievement of an optimal cytoreduction. The purpose of this manuscript was to discuss the rationale of liver resection and the morbidity related to this procedure in advanced and recurrent ovarian cancer.

Methods

A search of the National Library of Medicine’s MEDLINE/PubMed database until March 2015 was performed using the keywords: “ovarian cancer,” “hepatic,” “liver,” and “metastases.”

Results

In patients with liver metastases, hepatic resection is associated with a similar prognosis as stage IIIC patients. The length of the disease-free interval between primary diagnosis and occurrence of liver metastases, as well as residual disease after resection, is the most important prognostic factors. In addition, the number of liver lesions, resection margins, and the gynecologic oncology group performance status seem to play also an important role in determining outcome.

Conclusions

In properly selected patients, liver resections at the time of cytoreduction increase rates of optimal cytoreduction and improve survival in advanced-stage and recurrent ovarian cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abood G, Bowen M, Potkul R, Aranha G, Shoup M (2008) Hepatic resection for recurrent metastatic ovarian cancer. Am J Surg 195:370–373

    Article  PubMed  Google Scholar 

  • Adam R, Aloia T, Krissat J, Bralet MP, Paule B, Giacchetti S, Delvart V, Azoulay D, Bismuth H, Castaing D (2006a) Is liver resection justified for patients with hepatic metastases from breast cancer? Ann Surg 244:897–907

    Article  PubMed  PubMed Central  Google Scholar 

  • Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G, Association Française de Chirurgie (2006b) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244:524–535

    Article  PubMed  PubMed Central  Google Scholar 

  • Aletti GD, Podratz KC, Jones MB, Cliby WA (2006) Role of rectosigmoidectomy and stripping of pelvic peritoneum in outcomes of patients with advanced ovarian cancer—a preliminary report. J Am Coll Surg 203:521–526

    Article  PubMed  Google Scholar 

  • Alseidi A, Helton WS, Espat NJ (2006) Does the literature support an indication for hepatic metastasectomy other than for colorectal primary? J Gastrointest Surg 10(1):99–104

    Article  PubMed  Google Scholar 

  • Armstrong DK, Bundy B, Wenzel L et al (2006) Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354:34–43

    Article  CAS  PubMed  Google Scholar 

  • Bleicher RJ, Allegra DP, Nora DT, Wood TF, Foshag LJ, Bilchik AJ (2003) Radiofrequency ablation in 447 complex unresectable liver tumors: lessons learned. Ann Surg Oncol 10:52–58

    Article  PubMed  Google Scholar 

  • Bojalian MO, Machado GR, Swensen R, Reeves ME (2004) Radiofrequency ablation of liver metastasis from ovarian adenocarcinoma: case report and literature review. Gynecol Oncol 93(2):557–560

    Article  PubMed  Google Scholar 

  • Bristow RE, Montz FJ, Lagasse LD, Leuchter RS, Karlan BY (1999) Survival impact of surgical cytoreduction in stage IV epithelial ovarian cancer. Gynecol Oncol 72(3):278–287

    Article  CAS  PubMed  Google Scholar 

  • Bristow RE, Tomacruz RS, Armstrong DK, Trimble EL, Montz FJ (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a metaanalysis. J Clin Oncol 20:1248–1259

    Article  PubMed  Google Scholar 

  • Cannistra SA (2004) Cancer of the ovary. N Engl J Med 351:2519–2529

    Article  CAS  PubMed  Google Scholar 

  • Chalkiadakis GE, Lasithiotakis KG, Petrakis I, Kourousis C, Georgoulias V (2005) Major hepatectomy and right hemicolectomy at the time of primary cytoreductive surgery for advanced ovarian cancer: report of a case. Int J Gynecol Cancer 15(6):1115–1119

    Article  CAS  PubMed  Google Scholar 

  • Chi DS, McCaughty K, Diaz JP et al (2006) Guidelines and selection criteria for secondary cytoreductive surgery in patients with recurrent, platinum-sensitive epithelial ovarian carcinoma. Cancer 106:1933–1939

    Article  PubMed  Google Scholar 

  • Chi DS, Eisenhauer EL, Zivanovic O, Sonoda Y, Abu-Rustum NR, Levine DA, Guile MW, Bristow RE, Aghajanian C, Barakat RR (2009) Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol 114:26–31

    Article  PubMed  Google Scholar 

  • Du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J (2009) Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 115:1234–1244

    Article  PubMed  Google Scholar 

  • Eisenhauer EL, Abu-Rustum NR, Sonoda Y, Levine DA, Poynor EA, Aghajanian C, Jarnagin WR, DeMatteo RP, D’Angelica MI, Barakat RR, Chi DS (2006) The addition of extensive upper abdominal surgery to achieve optimal cytoreduction improves survival in patients with stages IIIC–IV epithelial ovarian cancer. Gynecol Oncol 103(3):1083–1090

    Article  PubMed  Google Scholar 

  • Eisenkop SM, Spirtos NM, Lin WC (2006) Splenectomy in the context of primary cytoreductive operations for advanced epithelial cancer. Gynecol Oncol 100:344–348

    Article  PubMed  Google Scholar 

  • Harter P, du Bois A, Hahmann M et al (2006) Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Ann Surg Oncol 13:1702–1710

    Article  PubMed  Google Scholar 

  • Jacobs IA, Chang CK, Salti G (2003) Hepatic radiofrequency ablation of metastatic ovarian granulosa cell tumors. Am Surg 69(5):416–418

    PubMed  Google Scholar 

  • Kanas GP, Taylor A, Primrose JN et al (2012) Survival after liver resection in metastatic colorectal cancer: review and metaanalysis of prognostic factors. Clin Epidemiol 4:283–301

    PubMed  PubMed Central  Google Scholar 

  • Kehoe S, Hook J, Nankivell M et al (2015) Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 386:249–257

    Article  PubMed  Google Scholar 

  • Kolev V, Pereira EB, Schwartz M, Sarpel U, Roayaie S, Labow D, Momeni M, Chuang L, Dottino P, Rahaman J, Zakashansky K (2014) The role of liver resection at the time of secondary cytoreduction in patients with recurrent ovarian cancer. Int J Gynecol Cancer 24(1):70–74

    Article  PubMed  Google Scholar 

  • Learn PA, Bach PR (2010) A decade of mortality reductions in major oncologic surgery: the impact of centralization and quality improvement. Med Care 48:1041–1049

    Article  PubMed  Google Scholar 

  • Lee YT (1984) Breast carcinoma: pattern of recurrence and metastasis after mastectomy. Am J Clin Oncol 7:443–449

    Article  CAS  PubMed  Google Scholar 

  • Lim MC, Kang S, Lee KS, Han SS, Park SJ, Seo SS, Park SY (2009) The clinical significance of hepatic parenchymal metastasis in patients with primary epithelial ovarian cancer. Gynecol Oncol 112(1):28–34

    Article  PubMed  Google Scholar 

  • Loizzi V, Rossi C, Cormio G, Cazzolla A, Altomare D, Selvaggi L (2005) Clinical features of hepatic metastasis in patients with ovarian cancer. Int J Gynecol Cancer 15(1):26–31

    Article  CAS  PubMed  Google Scholar 

  • Magtibay PM, Adams PB, Silverman MB, Cha SS, Podratz KC (2006) Splenectomy as part of cytoreductive surgery in ovarian cancer. Gynecol Oncol 102:369–374

    Article  PubMed  Google Scholar 

  • Mateo R, Singh G, Jabbour N, Palmer S, Genyk Y, Roman L (2005) Optimal cytoreduction after combined resection and radiofrequency ablation of hepatic metastases from recurrent malignant ovarian tumors. Gynecol Oncol 97(1):266–270

    Article  PubMed  Google Scholar 

  • Meredith MA, Cliby WA, Keeney GL, Lesnick TG, Nagorney DM, Podratz KC (2003) Hepatic resection for metachronous metastases from ovarian carcinoma. Gynecol Oncol 89:16–21

    Article  Google Scholar 

  • Nathan H, Cameron JL, Choti MA et al (2009) The volume-outcomes effect in hepato-pancreato-biliary surgery: hospital versus surgeon contribution and specificity of the relationship. J Am Coll Surg 208:528–538

    Article  PubMed  Google Scholar 

  • Neumann UP, Fotopoulou C, Schmeding M, Thelen A, Papanikolaou G, Braicu EI, Neuhaus P, Sehouli J (2012) Clinical outcome of patients with advanced ovarian cancer after resection of liver metastases. Anticancer Res 32(10):4517–4521

    PubMed  Google Scholar 

  • Niu G, Shen C, Cui W, Li Q (2012) Hepatic resection is safe for metachronous hepatic metastases from ovarian cancer. Cancer Biol Med 9:182–187

    PubMed  PubMed Central  Google Scholar 

  • Papadia A, Morotti M (2013) Diaphragmatic surgery during cytoreduction for primary or recurrent epithelial ovarian cancer: a review of the literature. Arch Gynecol Obstet 287:733–741

    Article  PubMed  Google Scholar 

  • Papadia A, Moya Y, Rodgers SE et al (2011) Surgical resection of recurrent upper abdominal cervical cancer: a case report and review of the literature. Gynecol Oncol Case Rep 1:8–9

    Article  PubMed  PubMed Central  Google Scholar 

  • Pekmezci S, Saribeyoglu K, Aytac E, Arvas M, Demirkiran F, Ozguroglu M (2010) Surgery for isolated liver metastasis of ovarian cancer. Asian J Surg 30(2):83–88

    Article  Google Scholar 

  • Peterhans M, vom Berg A A, Dagon B et al (2011) A navigation system for open liver surgery: design, workflow and first clinical applications. Int J Med Robot 7:7–16

    Article  CAS  PubMed  Google Scholar 

  • Prat J (2015) FIGO Committee on Gynecologic Oncology. Abridged republication of FIGO’s staging classification for cancer of the ovary, fallopian tube, and peritoneum. Cancer. doi:10.1002/cncr.29524

  • Roh HJ, Kim DY, Joo WD, Yoo HJ, Kim JH, Kim YM, Kim YT, Nam JH (2011) Hepatic resection as part of secondary cytoreductive surgery for recurrent ovarian cancer involving the liver. Arch Gynecol Obstet 284(5):1223–1229

    Article  PubMed  Google Scholar 

  • Rose PG, Piver MS, Tsukada Y, Lau TS (1989) Metastatic patterns in histologic variants of ovarian cancer. An autopsy study. Cancer 64:1508–1513

    Article  CAS  PubMed  Google Scholar 

  • Siegel R, Naishadham D, Jemal A (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29

    Article  PubMed  Google Scholar 

  • Tangjitgamol S, Levenback CF, Beller U, Kavanagh JJ (2004) Role of surgical resection for lung, liver, and central nervous system metastases in patients with gynecological cancer: a literature review. Int J Gynecol Cancer 14(3):399–422

    Article  CAS  PubMed  Google Scholar 

  • Veereman G, Robays J, Verleye L et al (2015) Pooled analysis of the surgical treatment for colorectal cancer liver metastases. Crit Rev Oncol/Hematol 94:122–135

    Article  CAS  Google Scholar 

  • Vergote I, Tropé CG, Amant FA et al (2010) Neoadjuvant chemotherapy or primary surgery in stage IIIc–IV ovarian cancer. N Engl J Med 363:943–953

    Article  CAS  PubMed  Google Scholar 

  • Weitz J, Blumgart LH, Fong Y, Jarnagin WR, D’Angelica M, Harrison LE et al (2005) Partial hepatectomy for metastases from noncolorectal, nonneuroendocrine carcinoma. Ann Surg 241:269–276

    Article  PubMed  PubMed Central  Google Scholar 

  • Winter WE III, Maxwell GL, Tian C, Sundborg MJ, Rose GS, Rose PG et al (2008) Tumor residual after surgical cytoreduction in prediction of clinical outcome in stage IV epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 26:83–89

    Article  PubMed  Google Scholar 

  • Yoon SS, Jarnagin WR, Fong Y, DeMatteo RP, Barakat RR, Blumgart LH, Chi DS (2003) Resection of recurrent ovarian or fallopian tube carcinoma involving the liver. Gynecol Oncol 91(2):383–388

    Article  PubMed  Google Scholar 

  • Zang RY, Harter P, Chi DS et al (2011) Predictors of survival in patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery based on the pooled analysis of an international collaborative cohort. Br J Cancer 105:890–896

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funding source supported the present investigation.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, “Sapienza” University of Rome, Rome, Italy

    Maria Luisa Gasparri & Pierluigi Benedetti Panici

  2. Department of Obstetrics and Gynecology, University of Modena, Modena, Italy

    Giovanni Grandi

  3. Department of Obstetrics and Gynecology, Inselspital, Berne University, Berne, Switzerland

    Maria Luisa Gasparri, Daniele Bolla, Sara Imboden, Michael D. Mueller & Andrea Papadia

  4. Department of Surgery, Inselspital, Berne University, Berne, Switzerland

    Beat Gloor

Authors
  1. Maria Luisa Gasparri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giovanni Grandi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniele Bolla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Beat Gloor
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sara Imboden
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Pierluigi Benedetti Panici
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael D. Mueller
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Andrea Papadia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Papadia.

Ethics declarations

Conflict of interest

The authors have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gasparri, M.L., Grandi, G., Bolla, D. et al. Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer. J Cancer Res Clin Oncol 142, 1509–1520 (2016). https://doi.org/10.1007/s00432-015-2090-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-015-2090-3

Keywords

Search

Navigation