Objectives To review the surgical outcomes of cytoreductive surgery for ovarian cancer in a single institution.

Methods we reviewed all patients with ovarian cancer who received a cytoreductive surgery between January 2005 and December 2018 at Hôtel-Dieu de France University Hospital, Lebanon.

Results 161 patients were included. Mean age at surgery was 54 years (range 16 – 83 years). Cytoreductive surgery was done in four settings: upfront surgery (40%), interval surgery post neoadjuvant chemotherapy (42%), post recurrence (7%), post incomplete primary surgery (11%). 67% of operated patients were in stage III. Surgical resection included bowel resection (48%), diaphragmatic peritoneal resection (25%) and splenectomy (15%). 89% of patients received a pelvic and para-aortic lymphadenectomy. Node involvement was noted in 48% of cases. No recurrence was seen in 56% of cases and the mean interval of recurrence was estimated at 21 months with 78% of recurrences occurring after 12 months from surgery. Overall survival was estimated at 40 months (range 2 – 165 months). No impact on survival was detected whether the patient benefited from an upfront surgery or an interval one post neoadjuvant chemotherapy: 36 months vs 30 months respectively, (p= 0.39). Better survival was encountered when only one lymph node was involved (85 months vs 42 months, p=0.037).Patients with LNR ≤ 0.03 had a survival of 50 months vs. 27 months in patients with LNR > 0.03.

Conclusions Huge efforts including extensive cytoreductive surgeries are being performed at institutions in developing countries in order to improve survival and lower recurrence in ovarian cancer patients.