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Short- and long-term morbidity of total parietal peritonectomy for advanced ovarian cancer
  1. Suguru Odajima1,2,
  2. Hiroshi Tanabe1,2,
  3. Yuki Koike2,
  4. Junki Onishi1,2,
  5. Teppei Ichikawa1,
  6. Kota Yokosu2,
  7. Shin Takaneka1 and
  8. Aikou Okamoto2
  1. 1 Department of Gynecology, National Cancer Center-Hospital East, Kashiwa, Chiba, Japan
  2. 2 Department of Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  1. Correspondence to Dr Hiroshi Tanabe, Department of Gynecology, National Cancer Center-Hospital East, Kashiwa, Chiba, Japan; htanabe{at}east.ncc.go.jp

Abstract

Objective Total parietal peritonectomy is gradually being recognized as a surgical option for advanced ovarian cancer; however, evidence regarding its efficacy and safety remains insufficient. Herein, we aimed to assess the short- and long-term post-operative safety profiles of total parietal peritonectomy.

Methods We reviewed the medical records of post-operative morbidity and mortality of patients who underwent cytoreductive surgery with total parietal peritonectomy for stage III and IV ovarian cancer between April 2018 and January 2023.

Results Fifty patients were enrolled in the study: 31 who underwent primary cytoreductive surgery and 19 who underwent interval cytoreductive surgery. The median age of all patients was 57 (range, 23–74) years. The median follow-up period was 22 (range, 3–59) months. Of 44 patients (88%) with stage IIIC/IV, 38 patients (76%) had high-grade serous carcinoma. The complete resection rates were 94%, 91%, and 100% in all patients, the primary cytoreductive surgery group, and the interval cytoreductive surgery group, respectively. There were 63 post-operative complication events overall, including 17 (27%) major complication events in 15 patients within 1 year post-operatively. Ten major complications occurred within 30 days of surgery, mainly in the primary cytoreductive surgery group (9 cases). Regarding complication type, the most frequent major event was pleural effusion (3 cases, 7%). After 30 days, there were a total of 17 all-grade complication events, of which ileus and hydronephrosis were major complications in 3 cases each (18%). There were no mortalities related to cytoreductive surgery. The scheduled adjuvant chemotherapy could be completed in 96% of patients.

Conclusions Total parietal peritonectomy is a feasible procedure for managing advanced ovarian cancer. Short- and long-term complications may include pleural effusion and ileus/hydronephrosis, respectively.

  • Carcinoma
  • Ovarian Neoplasms
  • Cytoreduction surgical procedures
  • Postoperative complications
  • Gynecologic Surgical Procedures

Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors Conceptualization: SO, HT. Date curation: SO, YK, JO, TI, KY. Investigation: SO, HT. Writing - original draft: SO, TH. Writing - review and editing: SO, YK, JO, TI, KY, ST, AO. Guarantor: HT.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.