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LIVER RESECTION IN RECURRENT OVARIAN GRANULOSA CELL TUMORSстатья Исследовательская статья
- Авторы: Polyakov Alexandr N., Patyutko Yurii I., Syskova Anna Y., Pokataev Ilya A., Chistyakova Olga V., Saakyan Margarita S., Magomedov Magomed M., Sukhanov Sergei A., Proskuryakov Ilya S., Suleymanova Hadijat A., Podluzhnyi Danila V.
- Журнал: Онкогинекология
- Номер: 3
- Год издания: 2020
- Издательство: Межрегиональная общественная организация "Общество специалистов онкологов по опухолям репродуктивной системы"
- Местоположение издательства: Москва
- Первая страница: 36
- Последняя страница: 45
- DOI: 10.52313/22278710_2020_3_36
- Аннотация: Objective of the study is to summarize the literature data on the liver resection in recurrent ovarian granulosa cell tumors (GCT), compare them with our own results, to determine the feasibility of liver resection in recurrent ovarian granulosa cell tumors (GCT). Materials and Methods. A retrospective analysis of medical records ofpatients, who had undergone treatment at Federal State Budgetary Institution “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Healthcare of the Russian Federation for the period from 2003 to 2020, was carried out. Inclusion criteria were morphologically verified ovarian granulosa cell tumor, recurrence with liver involvement and with the possibility of liver resection, the findings of instrumental examination. Results. 9 patients with recurrent ovarian granulosa cell tumors (GCT) of adult type with liver involvement were included into the study retrospectively, two of them had undergone anatomical liver resection, the rest - atypical resection (n=7). Five patients had received chemotherapy just prior to resection. More than one metastasis had been diagnosed in 3 patients. Liver spread had been, at a minimum, the second recurrence of ovarian granulosa cell tumor (GCT) in all the cases. 5 patients had required performing of en bloc diaphragm resection with liver resection. Intervention on extrahepatic metas-tases had been carried out in 7 cases. One case had been coded as R1 resection , and another case - as R2. Reactive hydro thorax had been identified in all patients with diaphragm resection (N = 5). In one case - in combination with pneumothorax, that had required drainage of the pleural space. Histological examination had revealed post-treatment pathologic changes of Grade I in 1 patient of 5 who had received preoperative (neoadjuvant) chemotherapy. Post-operative examination including ultrasound imaging of the abdomen and pelvis had been performed every three mon-ths, and monitoring of inhibin B level in blood serum - one month after the resection, and later - every three months. Median time to progression (MTTP) made up 15 months, median overall survival (MOS) reached 56 months. Two patients after liver resection underwent repeat surgical intervention for the recurrence of ovarian granulosa cell tumor (GCT). Conclusion. According to international literature sources that reported on a total of 18 patients who had undergone liver resection for recurrent ovarian granulosa cell tumor (GCT), surgical treatment in similar clinical situations is justified. It permits to mitigate symptoms of the disease at a low postoperative complication rate, as well as to achieve satisfactory long-term outcomes - at the time of publication of the reports - 12 patients lived for 10 to 168 months, in 6 patients long-term results were not conclusively tracked and investigated. In our study (n = 9) 5-year overall survival was 45,7%, median overall survival - 56 months, that is consistent with international literature data. Postoperative examination with mandatory inhibin B level control is indicated for an early detection of recurrence. The development of novel, more effec-tive systemic treatment regimens that can be used both as stand-alone treatment method and as supplementary treatment option after surgical intervention for recurrent ovarian granulosa cell tumor (GCT) is required. Keywords: GRANULOSA CELL TUMOR, RECURRENCE, LIVER INVOLVEMENT, LIVER RESECTION, INHIBIN B
- Добавил в систему: Поляков Александр Николаевич