Histological regression of peritoneal metastases of recurrent tubo-ovarian cancer after systemic chemotherapy

Basile Pache; Hugo Teixeira Farinha; Laura Toussaint; Nicolas Demartines; Delfyne Hastir; Patrice Mathevet; Christine Sempoux; Martin Hübner

doi:10.3389/fsurg.2022.936613

Histological regression of peritoneal metastases of recurrent tubo-ovarian cancer after systemic chemotherapy

Front Surg. 2022 Sep 23:9:936613. doi: 10.3389/fsurg.2022.936613. eCollection 2022.

Authors

Basile Pache^{1

2

3}, Hugo Teixeira Farinha^{1

3}, Laura Toussaint^{1

3}, Nicolas Demartines^{1

3}, Delfyne Hastir^{4

3}, Patrice Mathevet^{2

3}, Christine Sempoux^{4

3}, Martin Hübner^{1

3}

Affiliations

¹ Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
² Gynecology Unit, Department Women-Mother-Child, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.
³ Faculté de Biologie et Médecine, University of Lausanne, Lausanne (UNIL), Switzerland.
⁴ Department of Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.

Abstract

Introduction: Post-treatment histological regression of peritoneal metastases (PM) is a new and potentially important predictor of oncological outcomes. Histology of PM from adnexal origin is usually evaluated by the Chemotherapy Response Score (CRS). The aim of this preliminary study was to quantify the response of PM of recurrent tubo-ovarian cancer (TOVC) after systemic chemotherapy by using the recently validated Peritoneal Regression Grading System (PRGS) and compare it with CRS. Correlation with per operative evaluation through Peritoneal Cancer Index (PCI) was performed.

Material and methods: Retrospective cohort study of all consecutive patients with recurrent PM from TOVC undergoing surgery after prior systemic chemotherapy from January 2015 to March 2019. Biopsies were assessed with the four-scale PRGS.

Results: Thirty-eight patients were included. Patients had a median of 2 (range 1-2) lines and 12 (range 3-18) cycles of prior systemic chemotherapy. Overall mean (SD) PRGS was 2.3 (±1.1). Of the patients, 26% (10) had complete response (PRGS 1), 40% (15) had major response (PRGS 2), 26% (10) minor response (PRGS 3), and 8% (3) had no response (PRGS 4). Mean PRGS was positively correlated with the Peritoneal Cancer Index (ρ = 0.5302, p = 0.0003) and inversely correlated with CRS (ρ = -0.8403, p < 0.0001). No correlation was highlighted between mean PRGS and overall survival (ρ = -0.0195, p = 0.9073).

Conclusion: CRS and mean PRGS correlated with each other. Histological response of PM after systemic chemotherapy was quantifiable and variable. The role of PRGS for the evaluation of treatment response and as potential surrogate marker for oncological outcomes is part of ongoing and planned research.

Keywords: PRGS; chemotherapy; gynecology; histology; ovary; peritoneal metastasis; surgery.

Grants and funding

The research did not receive specific funding, but was performed as part of the employment of the authors, at the Lausanne University Hospital (CHUV), Switzerland. Open access funding was provided by the University of Lausanne.