Article Text
Abstract
Introduction/Background Surgical treatment is the cornerstone in the treatment of ovarian cancer in the primary and in some recurrent situations. Beside the evidence for significant effect on survival, complications caused by the tumor spread or due to techniques of resection are most formidable. There is no clear wich factors may play a predictive role.
Methodology Between 2010 and 2018 a retrospective analysis of all surgical interventions for primary advanced and recurrent ovarian, Fallopian tube or primary peritoneal cancer were identified. Retrospective analysis of classical patient´s and clinicopathological parameters, type of surgery with surgical techniques, type of complications and their management were evaluated prospectively with special focus on impact of treatment and prognosis.
Results Of 3486 identified surgeries for primary advanced and recurrent ovarian, Fallopian tube or primary peritoneal cancer we identified 4,1% surgical interventions to the urinary tract with partial resection of the bladder : 39 (17 primary, 22 recurrence), partial resection of the ureter(s): 19 (7 primary, 12 recurrence), cystectomy: 4 (all at recurrence), nephrectomy: 4. the rate of intraoperative injuries of the urinary tract was: 3.9% whit 59 bladder lesions (16 at primary, 20 at recurrence), 15 Ureterallesions (5 at primary, 10 at recurrence). The rate of renal vessel injuries was 0.5% (16 patients and 2 nephrectomies). The rate of post surgical urological complications (30d period) was 1.9% - 8 fistulas, 13 urinomas, 31 ureter obliterations. Furthermore we identified urological complications during the systemic treatment: 24 Fistulas (18 during Bevacizumab treatment).
Conclusion Urologic surgical interventions and rate of complications was in general low, but in the evaluated cohort they had a significant impact on clinical outcome and prognosis. Further evaluation of possible predictive factors to identify patients at risk for advanced surgical resection on the urinary tract and following complications is needed.
Disclosure Nothing to disclose.