Primary peritoneal serous papillary carcinoma: a case series
To present the clinical and laboratory characteristics, as well as the management, of patients with primary peritoneal serous papillary carcinoma (PPSPC).
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.
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.
PPSPC is a rare malignancy, the management of which should take place in tertiary oncology centers.
KeywordsPrimary peritoneal serous carcinoma Primary peritoneal serous papillary carcinoma PPSPC PPSC Peritoneal malignancy
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.
Compliance with ethical standards
Conflict of interest
We declare that we do not have any conflict of interest.
Informed consent was obtained from all alive individual participants or, in case of deceased patients, from their next of kin.
- 5.Eltabbakh HG, Piver MS (1998) Extraovarian primary peritoneal carcinoma. Cancer Netw Oncol (Williston Park) 12(6):813–819 (discussion 820, 825–6) 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 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 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 CrossRefGoogle 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 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 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):1387–1394Google 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):607–610Google 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 Google Scholar