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Primary peritoneal serous papillary carcinoma: a case series

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To present the clinical and laboratory characteristics, as well as the management, of patients with primary peritoneal serous papillary carcinoma (PPSPC).

Methods

This is a retrospective study of 19 patients with PPSPC who underwent debulking surgery followed by first line chemotherapy and were managed in Metaxa Memorial Cancer Hospital between January 2002 and December 2017.

Results

The median age of the patients was found to be 66 years (range 44–76 years). Clinical presentation of PPSPC included abdominal distention and pain, constipation, as well as loss of appetite and weight gain. Two of the patients did not mention any symptomatology and the disease was suspected by an abnormal cervical smear and elevated CA125 levels respectively. Biomarkers measurement during the initial management of the patients revealed abnormal values of CA125 for all the participants (median value 565 U/ml). Human epididymis secretory protein 4 (HE4) and ratios of blood count were also measured. Perioperative Peritoneal Cancer Index ranged from 6 to 20. Optimal debulking was achieved in 5 cases. All patients were staged as IIIC and IVA PPSPC and received standard chemotherapy with paclitaxel and carboplatin, whereas bevacizumab was added in the 5 most recent cases. Median overall survival was 29 months.

Conclusion

PPSPC is a rare malignancy, the management of which should take place in tertiary oncology centers.

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References

REFERENCES

  1. Swerdlow M (1959) Mesothelioma of the pelvic peritoneum resembling papillary cystadenocarcinoma of the ovary. Case report. Am J Obstet Gynecol. https://doi.org/10.1016/0002-9378(59)90287-X

    Article  PubMed  Google Scholar 

  2. Moss EL, Evans T, Pearmain P et al (2015) Should all cases of high-grade serous ovarian, tubal, and primary peritoneal carcinomas be reclassified as tubo-ovarian serous carcinoma? Int J Gynecol Cancer. https://doi.org/10.1097/IGC.0000000000000477

    Article  PubMed  Google Scholar 

  3. Liao CI, Chow S, Chen L et al (2018) Trends in the incidence of serous fallopian tube, ovarian, and peritoneal cancer in the US. Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2018.01.030

    Article  PubMed  Google Scholar 

  4. Bloss JD, Liao SY, Buller RE et al (1993) Extraovarian peritoneal serous papillary carcinoma: a case-control retrospective comparison to papillary adenocarcinoma of the ovary. Gynecol Oncol. https://doi.org/10.1006/gyno.1993.1223

    Article  PubMed  Google Scholar 

  5. Eltabbakh HG, Piver MS (1998) Extraovarian primary peritoneal carcinoma. Cancer Netw Oncol (Williston Park) 12(6):813–819 (discussion 820, 825–6)

    CAS  Google Scholar 

  6. Crum CP, Drapkin R, Miron A et al (2007) The distal fallopian tube: a new model for pelvic serous carcinogenesis. Curr Opin Obstet Gynecol 19(1):3–9

    Article  PubMed  Google Scholar 

  7. Nik NN, Vang R, Shih I-M, Kurman RJ (2013) Origin and pathogenesis of pelvic (Ovarian, Tubal, and Primary Peritoneal) serous carcinoma. Annu Rev Pathol Mech Dis. https://doi.org/10.1146/annurev-pathol-020712-163949

    Article  Google Scholar 

  8. Seidman JD, Zhao P, Yemelyanova A (2011) “Primary peritoneal” high-grade serous carcinoma is very likely metastatic from serous tubal intraepithelial carcinoma: assessing the new paradigm of ovarian and pelvic serous carcinogenesis and its implications for screening for ovarian cancer. Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2010.11.020

    Article  PubMed  Google Scholar 

  9. Suh-Burgmann E, Powell CB (2007) Cytoreductive surgery for gynecologic malignancies-new standards of care. Surg Oncol Clin N Am 16(3):667–682 (x–xi)

    Article  PubMed  Google Scholar 

  10. Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  Google Scholar 

  11. Zhu Y, Zhou S, Liu Y et al (2018) Prognostic value of systemic inflammatory markers in ovarian Cancer: a PRISMA-compliant meta-analysis and systematic review. BMC Cancer. https://doi.org/10.1186/s12885-018-4318-5

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jacquet P, Sugarbaker PH (1996) Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res 82:359–374

    Article  CAS  Google Scholar 

  13. González-Moreno S, Kusamura S, Baratti D, Deraco M (2008) Postoperative residual disease evaluation in the locoregional treatment of peritoneal surface malignancy. J Surg Oncol 98(4):237–241. https://doi.org/10.1002/jso.21072

    Article  PubMed  Google Scholar 

  14. Aletti GD, Dowdy SC, Podratz KC, Cliby WA (2007) Relationship among surgical complexity, short-term morbidity, and overall survival in primary surgery for advanced ovarian cancer. Am J Obstet Gynecol 197:676.e1–7. https://doi.org/10.1016/j.ajog.2007.10.495

    Article  Google Scholar 

  15. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae

    Article  PubMed  PubMed Central  Google Scholar 

  16. Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. https://doi.org/10.1016/j.ejca.2008.10.026

    Article  PubMed  Google Scholar 

  17. Aletti GD, Dowdy SC, Gostout BS et al (2006) Aggressive surgical effort and improved survival in advanced-stage ovarian cancer. Obstet Gynecol. https://doi.org/10.1097/01.AOG.0000192407.04428.bb

    Article  PubMed  Google Scholar 

  18. Wimberger P, Lehmann N, Kimmig R et al (2007) Prognostic factors for complete debulking in advanced ovarian cancer and its impact on survival. An exploratory analysis of a prospectively randomized phase III study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group (AGO-OVA). Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2007.02.026

    Article  PubMed  Google Scholar 

  19. Chi DS, Eisenhauer EL, Lang J et al (2006) What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol. https://doi.org/10.1016/j.ygyno.2006.03.051

    Article  PubMed  Google Scholar 

  20. Iavazzo C, Gkegkes ID, Vrachnis N (2016) Primary peritoneal cancer in BRCA carriers after prophylactic bilateral salpingo-oophorectomy. J Turkish Ger Gynecol Assoc. https://doi.org/10.5152/jtgga.2016.15223

    Article  Google Scholar 

  21. Sørensen RD, Schnack TH, Karlsen MA (2015) Høgdall CK Serous ovarian, fallopian tube and primary peritoneal cancers: a common disease or separate entities—a systematic review. Gynecol Oncol 136(3):571–581. https://doi.org/10.1016/j.ygyno.2015.01.534

    Article  PubMed  Google Scholar 

  22. Neuhausen SL et al (2017) Primary peritoneal serous carcinoma in men: a rare and Non-BRCA-associated Entity. Anticancer Res. https://doi.org/10.21873/anticanres.11662

    Article  PubMed  Google Scholar 

  23. Hata J, Araki A, Morimoto T et al (2004) Extraovarian primary peritoneal carcinoma in a child. Pediatr Blood Cancer. https://doi.org/10.1002/pbc.10236

    Article  PubMed  Google Scholar 

  24. Steinhagen PR, Sehouli J (2011) The involvement of retroperitoneal lymph nodes in primary serous-papillary peritoneal carcinoma. A systematic review of the literature. Anticancer Res 31(4):1387–1394

    PubMed  Google Scholar 

  25. Sakakibara Y, Endo S, Yoshida Y et al (2011) A case of serous surface papillary carcinoma of the peritoneum metastatic to the brain. No Shinkei Geka 39(6):607–610

    PubMed  Google Scholar 

  26. Recine MA, Deavers MT, Middleton LP et al (2004) Serous carcinoma of the ovary and peritoneum with metastases to the breast and axillary lymph nodes: a potential pitfall. Am J Surg Pathol. https://doi.org/10.1097/00000478-200412000-00015

    Article  PubMed  Google Scholar 

  27. Nakao M, Oguri T, Maeno K et al (2009) Endobronchial metastasis from primary papillary serous carcinoma of the peritoneum. Intern Med. https://doi.org/10.2169/internalmedicine.48.2140

    Article  PubMed  Google Scholar 

  28. Yuan J, He L, Han B, Li Y (2017) Long-term survival of high-grade primary peritoneal papillary serous adenocarcinoma: a case report and literature review. World J Surg Oncol. https://doi.org/10.1186/s12957-017-1134-3

    Article  PubMed  PubMed Central  Google Scholar 

  29. Chiou SY, Sheu MH, Wang JH, Chang CY (2003) Peritoneal serous papillary carcinoma: a reappraisal of CT imaging features and literature review. Abdom Imaging 28(6):815–819

    Article  CAS  PubMed  Google Scholar 

  30. Furukawa T, Ueda J, Takahashi S et al (1999) Peritoneal serous papillary carcinoma: Radiological appearance. Abdom Imaging. https://doi.org/10.1007/s002619900446

    Article  PubMed  Google Scholar 

  31. Piek JM, Kenemans P, Verheijen RH (2004) Intraperitoneal serous adenocarcinoma: a critical appraisal of three hypotheses on its cause. Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2004.02.067

    Article  PubMed  Google Scholar 

  32. Iavazzo C, Vorgias G, Katsoulis M et al (2008) Primary peritoneal serous papillary carcinoma: clinical and laboratory characteristics. Arch Gynecol Obstet. https://doi.org/10.1007/s00404-008-0678-4

    Article  PubMed  Google Scholar 

  33. Harter P, Sehouli J, Lorusso D et al (2019) A randomized trial of lymphadenectomy in patients with advanced ovarian neoplasms. N Engl J Med. https://doi.org/10.1056/NEJMoa1808424

    Article  PubMed  Google Scholar 

  34. Unal OU, Oztop I, Yazici O et al (2014) Treatment and prognostic factors in primary peritoneal carcinoma: a multicenter study of the anatolian society of medical oncology (ASMO). Oncol Res Treat. https://doi.org/10.1159/000362857

    Article  PubMed  Google Scholar 

  35. Musella A, Vertechy L, Romito A et al (2016) Bevacizumab in ovarian cancer: state of the art and unanswered questions. Chemotherapy. https://doi.org/10.1159/000448942

    Article  PubMed  Google Scholar 

  36. Aghajanian C, Blank SV, Goff BA et al (2012) OCEANS: A randomized, double-blind, placebo-controlled phase III trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. J Clin Oncol. https://doi.org/10.1200/JCO.2012.42.0505

    Article  PubMed  PubMed Central  Google Scholar 

  37. Moore K, Colombo N, Scambia G et al (2019) Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. Obstet Gynecol Surv N Engl J Med 379(26):2495–2505. https://doi.org/10.1056/NEJMoa1810858

    Article  Google Scholar 

  38. Ceresoli M, Verrengia A, Montori G et al (2018) Effect of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy on relapse pattern in primary epithelial ovarian cancer: a propensity score based case-control study. J Gynecol Oncol. https://doi.org/10.3802/jgo.2018.29.e53

    Article  PubMed  PubMed Central  Google Scholar 

  39. Van Driel WJ, Koole SN, Sikorska K et al (2018) Hyperthermic intraperitoneal chemotherapy in ovarian cancer. Obstet Gynecol Surv N Engl J Med 378(3):230–240. https://doi.org/10.1056/NEJMoa1708618

    Article  CAS  Google Scholar 

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Authors and Affiliations

Authors

Contributions

NB: data collection, data analysis, manuscript writing, EV: data collection, manuscript writing, manuscript editing, GV: project development, data analysis, NK: project development, validation, CI: project development, data analysis, manuscript editing.

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Correspondence to Nikolaos Blontzos.

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Informed consent was obtained from all alive individual participants or, in case of deceased patients, from their next of kin.

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Blontzos, N., Vafias, E., Vorgias, G. et al. Primary peritoneal serous papillary carcinoma: a case series. Arch Gynecol Obstet 300, 1023–1028 (2019). https://doi.org/10.1007/s00404-019-05280-z

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