The Role of Bowel Surgery with Cytoreduction for Epithelial Ovarian Cancer

• Published in: Clinical oncology (Royal College of Radiologists (Great Britain)) Vol. 19; no. 10; pp. 757 - 762
• Main Authors: Cai, H.-B, Zhou, Y.-F, Chen, H.-Z, Hou, H.-Y
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2007
• Subjects: Adult; Advanced ovarian cancer; Age Factors; Aged; bowel resection; Case-Control Studies; Cohort Studies; Colectomy - adverse effects; debulking operation; Female; Gynecologic Surgical Procedures - adverse effects; Hematology, Oncology and Palliative Medicine; Humans; Intestine, Large - surgery; Intestine, Small - surgery; Kaplan-Meier Estimate; Middle Aged; Neoplasm, Residual - complications; Neoplasms, Glandular and Epithelial - surgery; Ovarian Neoplasms - surgery; Radiology; Retrospective Studies; Advanced ovarian cancer; bowel resection; debulking operation
• ISSN: 0936-6555; 1433-2981
• DOI: 10.1016/j.clon.2007.06.015

Abstract Aims To assess the efficiency and morbidity associated with bowel resection with the initial cytoreduction procedure for advanced ovarian cancer. Materials and methods A review was carried of 95 patients with ovarian cancer who underwent cytoreductive surgery between 2000 and 2003. The relationship between dichotomised preoperative, intra-operative and postoperative outcome variables were tested using SPSS software. Kaplan–Meier curves were generated to compare survival. Cox proportional hazards regression was used to determine the independent significance of factors after cytoreductive surgery. Results In patients in whom bowel resection was carried out, the largest residual tumour mass was <1 cm in 66.67% of patients, compared with 45.28% of patients undergoing surgery without bowel resection ( P = 0.038). The median survival in the optimally debulked patients was 50.38 months compared with 37.15 months in the patients who had suboptimal cytoreduction ( P = 0.0021). The median survival in patients undergoing bowel resection was 50.70 months compared with 44.62 months in the patients who had cytoreduction without bowel resection ( P = 0.2176). Multivariate analysis showed that optimal cytoreduction ( P = 0.005) was found to be independently prognostic for overall survival. Major adverse events, such as ileus, intestinal fistulae, urinary tract fistulae, were not significantly different between groups. Conclusion Bowel resection is a worthwhile endeavour in selected patients with advanced ovarian cancer to increase therapeutic efficiency. The surgical morbidity rate from these procedures is not serious and seems acceptable.