Prognostic Impact of Additional Extended Surgical Procedures in Advanced-Stage Primary Ovarian Cancer

• Published in: Annals of surgical oncology Vol. 17; no. 1; pp. 279 - 286
• Main Authors: Kommoss, S., Rochon, J., Harter, P., Heitz, F., Grabowski, J. P., Ewald-Riegler, N., Haberstroh, M., Neunhoeffer, T., Barinoff, J., Gomez, R., Traut, A., du Bois, A.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 2010; Springer Nature B.V
• Subjects: Adenocarcinoma, Clear Cell - pathology; Adenocarcinoma, Clear Cell - surgery; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adult; Aged; Aged, 80 and over; Carcinoma, Papillary - pathology; Carcinoma, Papillary - surgery; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - surgery; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Female; Follow-Up Studies; Gynecologic Oncology; Humans; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Ovarian cancer; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Prognosis; Retrospective Studies; Surgery; Surgical Oncology; Survival Rate; Complete Tumor Resection; Complete Cytoreduction; Eastern Cooperative Oncology Group Performance Status; Primary Debulking Surgery; Eastern Cooperative Oncology Group
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-009-0787-8

Background Treatment of advanced-stage ovarian carcinoma includes radical cytoreductive surgery, which aims at removing all visible tumor tissue followed by platinum and paclitaxel chemotherapy. Complete tumor resection may require extended surgical procedures. This paper reports on the prognostic impact of extensive surgery and surgical morbidity in patients with advanced-stage ovarian carcinoma. Methods Patients with ovarian carcinoma [Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) stage IIIB–IV] undergoing primary surgery in our tertiary gynecologic oncology unit between 1997 and 2007 were eligible for this study. The impact of established prognostic factors and the interaction with extent of surgical procedures on survival were assessed. Results A total of 267 patients aged between 29 and 88 years (median 64 years) were eligible for this study. Overall survival time was improved in patients who underwent complete tumor resection [hazard ratio (HR) 3.61 (1.91–6.61), P  < 0.001]. No significant survival difference was observed between completely operated patients in whom extended or standard surgical procedures were applied [HR 1.37 (0.70–2.69), P  = 0.358], and severe surgical complications were found to be equally distributed between the two patient groups. Conclusions Our results may encourage the application of extended surgical procedures in patients who would otherwise be rendered incompletely debulked after primary cytoreduction. We could demonstrate an impact of complete tumor resection on patient prognosis and this was not traded off for extensive additional surgical morbidity.