Prognostic factors value of germline and somatic brca in patients undergoing surgery for recurrent ovarian cancer with liver metastases. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Gallotta, Valerio; Conte, Carmine; D'Indinosante, Marco; Capoluongo, Ettore; Minucci, Angelo; De Rose, Agostino Maria; Ardito, Francesco; Giuliante, Felice; Di Giorgio, Andrea; Zannoni, Gian Franco; Fagotti, Anna; Margreiter, Christian; Scambia, Giovanni; Ferrandina, Gabriella
• Is Part Of: European journal of surgical oncology. Volume 45:Issue 11(2019)
• Page Start: 2096
• Page End: 2102
• Publication Date: 2019-11
• Subjects: Hepatic metastasis -- Recurrent ovarian cancer -- Secondary cytoreduction -- BRCA gene mutational status -- Personalized medicine; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2019.06.023
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Objective: To describe accurately the oncological outcomes after hepatic resection (HR) in recurrent ovarian carcinoma (ROC) evaluating clinic-pathological variables and mutational status of BRCA1/2. Although HR is considered a challenging situation in ROC patients, assessment of BRCA1/2 mutational status seems to have a relevant clinical value to guide surgical therapy. Methods: Patients who underwent HR for ROC at the Catholic University of Rome, between June 2012 and October 2017 were included. Exclusion criteria were represented by extra-abdominal disease and presence of diffuse peritoneal carcinomatosis requiring more than 2 bowel resections. Details relative to HR were collected and BRCA analysis was performed. Predictive factors of post-HR progression free survival (PHR-PFS) were assessed by univariate analyses using Cox-proportional hazard regression models. Results: Thirty-four patients undewent HR within secondary cytoreductive surgery (SCS). Six patients (17.6%) presented with hepatic relapse only, while the remaining 28 patients (82.4%) had concomitant extra-hepatic disease. In the whole series, the 3-yr PHR-PFS was 49.1% and the 3-yr post-HR overall survival was 72.9%. Univariate analysis of variables conditioning PHR-PFS showed that only BRCA mutational status played a statistically significant favourable role: the 3-yr PHR-PFS rate was 81.0% in BRCA mutated patient compared to 15.2% in wild type ones (p value: 0.001). Conclusions: Our clinical analyses suggest that in ROC patients with liver disease the assessment of germline and somatic BRCA mutational status can help to select patients elegible for SCS.