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Abstract
Introduction To analyze the influence of bowel resection or bowel tumor stripping on the prognosis of patients with advanced epithelial ovarian cancer.
Methods 255 Patients diagnosed as stage III-IV epithelial ovarian cancer with bowel metastasis at single cancer center from Jan. 1st, 2015 to Dec. 31st 2020 were enrolled for retrospective analysis, and divided into two groups, one was bowel resection group (101 cases) the other was bowel tumor stripping group (154 cases).
Results In this cohort study R0 rate reached 75.4%. More stage IV and higher surgical complexity score patients were found in the bowel resection group than in tumor stripping group (P=0.021). The incidence of intraoperative blood infusion, pneumonia and pleural effusion in the bowel resection group was significantly higher than that in the bowel tumor stripping group. The incidence of anastomotic fistula was 1.98% in the bowel resection group vs 0% in the tumor striping group. 5-year overall survival (OS) and 5-year progression free survival (PFS) were similar between resection group and stripping group respectively, 65.8% vs 73.8%, 70.6% vs 80.3%. If the residual lesions were left only on intestinal wall, 5-year OS was not different from that in R0 bowel resection group, but 5-year PFS was much lower (P=0.032). If cytoreductive surgery reached R0, no matter PDS or IDS, 5-year OS and 5-year PFS were similar between two groups.
Conclusion/Implications If R0 cytoreductive surgery was achieved, there was no negative effect of bowel tumor stripping for prognosis of advanced ovarian cancer. Excessive bowel resection did not increase overall survival.
