Cut it out

Prognostic value of peritoneal scar-like tissue in patients with peritoneal metastases of ovarian origin presenting for curative-intent cytoreductive surgery 

https://tinyurl.com/yeuerz2z

    The single most important determinant of survival from ovarian cancer is the completeness of removal of the primary tumour and any metastases at the time of the initial surgery. This involves extensive surgery for many women. Often the tumour metastasises to the lining of the abdominal cavity; the peritoneum. 

    Determining the extent of involvement is problematic, recent techniques using fluorescent dye have assisted in more clearly showing additional involvement. However, the positive predictive value is low at 57% meaning that it is still difficult to discriminate between thickened peritoneum due to scarring, and metastasis. 

    This retrospective study looks at almost 200 women with ovarian cancer who had extensive clearance surgery including removal of any thickened peritoneum regardless of whether it was suspicious for metastasis. 40% of the women had peritoneal scar-like tissue and metastatic cancer was seen in 50% of the additional resected tissue. 

    A high index of suspicion is appropriate in assessing the presence of cancer spread; “If in doubt, cut it out”.