|
|
|
|
|
|
|
|
abstract/open access (pdf)
Objectives: Extensive surgical efforts to achieve an optimal
debulking (no residual tumor) in primary surgery of ovarian cancer are
today's criterion standard in gyneco-oncologic surgery. However, it is
controversial whether extensive surgery, including resections of
metastases in the upper abdomen and bowel resections, is justifiable in
patients with not completely operable lesions.
Methods: All patients who had undergone surgery for
ovarian cancer in the years 2002 to 2013 at our institution were viewed
(n = 472). We retrospectively identified 278 operations for primary
ovarian cancer. Ninety-six (35%) of the 278 patients showed
postoperative tumor residuals and were included in this study.
Results: Fifty-five (57%) of 96 patients underwent bowel
resection, showing significantly higher complication rates (64% vs 39%
minor complications, P = 0.017; 31% vs 9.8% severe complications, P =
0.013) compared with patients without bowel resections as well as no
improvement in progression-free or overall survival (median overall
survival, 19.5 vs 32.9; P = 0.382). Multiple anastomoses (>=2) were
associated with higher rates for anastomotic leakage (16.7% vs 2.6%, P =
0.02) and a higher mortality (16.7% vs 0%, P = 0.04) compared with
patients with only 1 anastomosis. Extensive surgery of the upper abdomen
was not associated with a significant increase in complication rates.
Conclusions: Because of the increased morbidity of bowel
resections without any evidence for improvement of survival, we suggest
to restrain from further resection of intestines if an optimal debulking
seems not feasible after removal of the major tumor bulk.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.