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Long-term prognostic significance of ascites cytology in ovarian cancer cases in which R0 resection was achieved in the initial surgery : A multi-institutional retrospective cohort study

Iyoshi, Shohei ; Sunohara, Mayuko ; Yoshihara, Masato ; Kunishima, Atsushi ; Miyamoto, Emiri ; Fujimoto, Hiroki ; Kitami, Kazuhisa ; Mogi, Kazumasa ; Uno, Kaname LU orcid and Yoshida, Kosuke , et al. (2025) In Japanese journal of clinical oncology 55(7). p.743-750
Abstract

Background In ovarian cancer (OvCa), achieving complete resection (RO) in initial surgery is crucial for improving prognosis. However, patients with undetected microscopic metastasis post-RO surgery often have poorer outcomes. This study explores prognostic factors for OvCa patients who underwent RO surgery, focusing on the role of ascites cytology as an indicator of microscopic peritoneal metastasis. Methods We analyzed data from 975 OvCa cases in the Tokai Ovarian Tumor Study Group database (1986-2019). Excluding patients without chemotherapy or with distant metastasis, we examined prognostic factors using Cox regression analysis. Propensity score (PS) methods balanced the cytology-positive and -negative groups, with subgroup analysis... (More)

Background In ovarian cancer (OvCa), achieving complete resection (RO) in initial surgery is crucial for improving prognosis. However, patients with undetected microscopic metastasis post-RO surgery often have poorer outcomes. This study explores prognostic factors for OvCa patients who underwent RO surgery, focusing on the role of ascites cytology as an indicator of microscopic peritoneal metastasis. Methods We analyzed data from 975 OvCa cases in the Tokai Ovarian Tumor Study Group database (1986-2019). Excluding patients without chemotherapy or with distant metastasis, we examined prognostic factors using Cox regression analysis. Propensity score (PS) methods balanced the cytology-positive and -negative groups, with subgroup analysis for clinical stage and ascites volume. Results Multivariate analysis identified FIGO stage III and positive ascites cytology as poor prognostic factors for overall and progression-free survival. After PS adjustment, positive ascites cytology also shortened progression-free intervals post-recurrence, especially in cases with peritoneal or lymph node metastasis. Subgroup analysis revealed a more substantial prognostic impact of positive ascites cytology in early-stage cases. Conclusion The present results suggest that in OvCa patients with the R0 status, the presence of tumor cells in ascites is an independent negative prognostic factor and may be an indicator of peritoneal micro-metastasis.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ascites cytology, micro-metastasis, ovarian cancer, R0 surgery
in
Japanese journal of clinical oncology
volume
55
issue
7
pages
8 pages
publisher
Oxford University Press
external identifiers
  • pmid:40111097
  • scopus:105010265926
ISSN
0368-2811
DOI
10.1093/jjco/hyaf046
language
English
LU publication?
yes
id
f9a26b63-c27d-412c-838f-f256537d43b8
date added to LUP
2025-12-12 14:55:12
date last changed
2025-12-13 03:32:56
@article{f9a26b63-c27d-412c-838f-f256537d43b8,
  abstract     = {{<p>Background In ovarian cancer (OvCa), achieving complete resection (RO) in initial surgery is crucial for improving prognosis. However, patients with undetected microscopic metastasis post-RO surgery often have poorer outcomes. This study explores prognostic factors for OvCa patients who underwent RO surgery, focusing on the role of ascites cytology as an indicator of microscopic peritoneal metastasis. Methods We analyzed data from 975 OvCa cases in the Tokai Ovarian Tumor Study Group database (1986-2019). Excluding patients without chemotherapy or with distant metastasis, we examined prognostic factors using Cox regression analysis. Propensity score (PS) methods balanced the cytology-positive and -negative groups, with subgroup analysis for clinical stage and ascites volume. Results Multivariate analysis identified FIGO stage III and positive ascites cytology as poor prognostic factors for overall and progression-free survival. After PS adjustment, positive ascites cytology also shortened progression-free intervals post-recurrence, especially in cases with peritoneal or lymph node metastasis. Subgroup analysis revealed a more substantial prognostic impact of positive ascites cytology in early-stage cases. Conclusion The present results suggest that in OvCa patients with the R0 status, the presence of tumor cells in ascites is an independent negative prognostic factor and may be an indicator of peritoneal micro-metastasis.</p>}},
  author       = {{Iyoshi, Shohei and Sunohara, Mayuko and Yoshihara, Masato and Kunishima, Atsushi and Miyamoto, Emiri and Fujimoto, Hiroki and Kitami, Kazuhisa and Mogi, Kazumasa and Uno, Kaname and Yoshida, Kosuke and Tamauchi, Satoshi and Yokoi, Akira and Niimi, Kaoru and Yoshikawa, Nobuhisa and Emoto, Ryo and Matsui, Shigeyuki and Kajiyama, Hiroaki}},
  issn         = {{0368-2811}},
  keywords     = {{ascites cytology; micro-metastasis; ovarian cancer; R0 surgery}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{743--750}},
  publisher    = {{Oxford University Press}},
  series       = {{Japanese journal of clinical oncology}},
  title        = {{Long-term prognostic significance of ascites cytology in ovarian cancer cases in which R0 resection was achieved in the initial surgery : A multi-institutional retrospective cohort study}},
  url          = {{http://dx.doi.org/10.1093/jjco/hyaf046}},
  doi          = {{10.1093/jjco/hyaf046}},
  volume       = {{55}},
  year         = {{2025}},
}