Introduction/Background Debulking surgery for advanced-stage ovarian cancer often necessitates performance of demanding surgical operations. Main objective of the present cohort is to report rates of mental, nodal and bowel invasion in the context of debulking procedures.

Methodology A prospective observational cohort was performed concerning patients treated with a diagnosis of advanced-stage ovarian cancer. Epidemiological, histopathological and survival outcomes of all patients were prospectively recorded in a computerized database. The present study concerned patients treated between 2020–2022 either with primary cytoreduction or interval debulking surgery. There were studied all cases in which infragastric omentectomy, pelvic and/or para-aortic lymphadenectomy and any type of bowel resection was performed. Main outcome was to assess the overall invasion rate of relatively resected tissues.

Results There were overall 98 debulking surgeries for advanced-stage ovarian cancer performed during study period. Mean age of patients was 58.6 ± 12.1 years (range 37–80). All patients underwent infragastric omentectomy, while there were overall 19 bowel resections and 26 pelvic and 26 para-aortic lymphadenectomies performed. Specifically, 21 patients underwent both pelvic and para-aortic lymphadenectomy, while there were 5 with only pelvic and 5 with only para-aortic lymphadenectomy. Omental invasion was observed in 39.7% of cases (39/98). Pelvic nodal invasion was documented only in 5 out of 26 cases (19.2%) and para-aortic nodal invasion in 9 out of 26 cases (34.6%). In contrary, bowel invasion was reported in 89.4% of cases (17/19). No significant difference was observed regarding omental, nodal and bowel invasion rates between primary cytoreductive or neoadjuvant chemotherapy patients.

Conclusion Only 1 out of 3 patients where lymphadenectomy was performed in the context of cytoreductive surgery presented true invasion. In contrary, rate of bowel invasion was remarkably high. Lymphadenectomy should be performed only in case of high suspicion for nodal involvement based on cautious assessment of preoperative imaging and intraoperative evaluation.

Disclosures Authors have nothing to disclose