Introduction Ovarian cancer is diagnosed at an advanced stage (FIGO stage IIIC-IV) in approximately 60–80% of cases and aggressive, complex surgical procedures are often needed to achieve an optimal cytoreduction. Liver metastasis is one of the most common organs for metastasis portending a poor prognosis. We present a surgical video of non-anatomical liver resection (wedge resection) for oligometastatic disease in a case of high-grade serous carcinoma ovary during interval cytoreductive surgery.
Description 34-year P2L2A2 with high-grade serous carcinoma right ovary post right salpingo-oophorectomy with persistent solitary liver metastasis after 4 cycles of neoadjuvant chemotherapy for liver resection is presented. Intra-operatively, peritoneal washings, total abdominal hysterectomy, left salpingo-oophorectomy, retroperitoneal lymph node sampling, supracolic omentectomy and excision of 2×2 cm peritoneal deposit adjacent to segment VI of liver was done. Intra-operative USG was used to localize the intraparenchymal lesion in segment IV/V of liver which measured 2.5×2 cm. Non-anatomical liver resection was done with adequate resection margins after ligation of distal middle hepatic vein. Post-operative course was uneventful and final histopathology reported the lesion and peritoneal deposit to be positive for metastatic carcinoma.
Conclusion/Implications Non-anatomical liver resection should become part of cytoreductive surgery, especially in surgically approachable oligometastatic disease. Feasibility of liver resection has recently been reported in a systematic review. However further studies are needed to address the prognostic impact of liver resections.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.