Safety / feasability study of peritonectomy for advanced ovarian/peritoneal cancer

1. Peritonectomy Is this a realistic, safe and viable option for improving ovarian cancer cytoreductive surgery? Alex J Crandon & Marcelo Carraro Nascimento Qld Centre for Gyn. Cancer

3. Residual Disease –v- Survival in Advanced EOC 16 (>2cm) 45 (<2cm) Delgado, G 1984 16 (>2cm) 45 (<2cm) Pohl, R 1984 14 (>2cm) 25+ (<2cm) Conte, P 1985 8 ( >1cm) 19 ( ≤1cm) Zang, RY 2000 18 (>2cm) 30+ (<2cm) Posada, JG 1985 15 ( ≥2cm) 24 (<2cm) Louie, KG 1986 21 (>3cm) 72 ( ≤3cm) Hainsworth, J 1988 21 (>1cm) 48 ( ≤1cm) Piver, MS 1988 23 ( ≥3cm) 45 (<3cm) Sutton, GP 1989 15 (>2cm) 25 ( ≤2cm) Munkarah 1997 10 ( >1cm) 38 ( ≤1cm) Bristow, RE 1999 Suboptimal debulking Survival (months) Optimal debulking Survival (months) Study

6. Stage 3C EOC Breakdown 100 701 Total 24.1 169 Unknown 9.3 65 Gross 6.4 45 >2cm 8.6 60 1-2cm 32.4 227 <1cm 19.3 135 Nil Percent Number Residual Disease

7. Stage IIIC EOC Residual Disease –v- Disease Specific Survival

8. Stage IIIC EOC Residual Disease and Relapse Free Survival

17. Peritonectomy Positioning

20. Peritonectomy Patients Died of bowel obstruction FOD ?PD ?PD FOD FOD FOD DOD SD FOD Recurrence (L & H) FOD Status 2 7.5 3C R Ovary 77 PP 3 14 3C Peritoneum 53 SW 7 10.25 3C R Ovary 66 ES 4 17 D R Appendix 61 VM 8 13 3C R Ovary 57 SM 0 10.25 4 R Mesothelioma 40 KC 3 10 3C Ovary 60 SD 3 5.75 4 R Mesothelioma 59 ML 0 5 3C R Peritoneum 59 IK 3 8.5 3C Peritoneum 74 MT 0 5 3C Ovary 65 VW 0 5.5 3C R Ovary 54 SB Intra-op Transfusion (units) Operative Time (hrs) Stage Primary Disease Site Age Patient

26. Where could we be? 100 20.2 8.8 8.8 60.3 Modified Peritonectomy 100 886 Total 20.2 179 Unknown 8.8 78 Gross 8.8 78 >2cm 10.3 92 1-2cm 34.1 302 <1cm 17.8 158 Nil Percent Number Residual Disease