[The role of intestinal resection in primary surgery of ovarian carcinoma].
In most ovarian cancer cases complete resection of the tumour masses is not possible, and tumour reduction at the primary operation has been shown to improve survival. In some cases optimal tumour reduction is only possible by resecting intestinal structures, and it remains to be shown whether aggressive approaches are justified. The impact of intestinal resection, among other prognostic factors, was analysed in 104 patients undergoing primary operation for ovarian cancer. Tumour spread to bowel, exceeding 2 cm in diameter occurred in 39% of the cases. Debulking to a maximal tumour diameter less than 2 cm was achieved in 68 (65%) cases. Successful debulking was achieved by performing large (n = 20) and small bowel (n = 4) in 22 patients with massive bowel involvement. Two patients died during the hospital stay, one after bowel resection. Four independent prognostic variables emerged from Cox's multiple proportional hazards regression: ascites (p = 0.001), massive bowel involvement (p = 0.007), residual tumour size (p = 0.002), and intestinal resection (p = 0.11). The authors contend that intestinal resection to achieve optimal tumour debulking at the primary operation will improve the survival of ovarian cancer patients.
Miholic
J
J
II. Chirurgische Universitätsklinik, II. Universitäts-Frauenklinik, Allgemeines Krankenhaus Wien.
Kölbl
H
H
Hanzal
E
E
Gitsch
G
G
Schemper
M
M
Moeschl
P
P
Janisch
H
H
Wolner
E
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D001201:Ascites / Q000150:complications; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000601:surgery; D007420:Intestine, Large / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models
Die Rolle von Darmresektionen bei der Erstoperation des Ovarialkarzinoms.