Introduction/Background Epithelial ovarian cancer (EOC) is the most lethal gynaecologic malignancy. Most patients present with advanced stage disease. The most important prognostic factor is cytoreduction to no macroscopic residual tumour, which could require the addition of extensive surgical procedures to standard procedures, as diaphragmatic surgery or bowel resection. These procedures improve complete resection rate and subsequent survival of patients with advanced EOC.
The aim of this study is to describe the use of extensive surgical procedures in our centre and their impact in terms of results and postoperative complications.
Methodology A consecutive series of 54 patients with newly diagnosed EOC operated between 2017 and 2018 at Dr. Josep Trueta University Hospital was analysed. Data were retrieved from the departmental database and hospital electronic medical records.
Results 42 patients (77%) were diagnosed at III/IV FIGO stage and underwent cytoreductive surgery. Of them, 46.5% had primary cytoreductive surgery, while 53.5% underwent surgery following neo-adjuvant chemotherapy.
Additional surgical procedures required to achieve no residual tumour outside of the ‘standard’ procedures are summarized.
No macroscopic residual disease was observed in 89.4% of cases, while 2.1% had residual disease ≤ 1 cm and 8.5% >1 cm.
Patients were classified in three groups according to the extent of surgery: only standard procedures, standard procedures plus bowel resection and extensive upper abdominal surgery with or without bowel resection. Results in the three groups were compared.
Although the median operating time, hospital stay and PCI was significantly higher in upper abdominal group, the rate of major surgical complications was not significantly different. There was no mortality within 30 days of surgery.
Conclusion The incorporation of extensive surgical procedures is feasible with acceptable morbidity. These procedures could improve the rate of complete cytoreduction and consequently the survival. Dedicated trained teams are needed to achieve the best outcomes in terms of complete cytoreduction and morbidity.
Disclosure Nothing to disclose.
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