title: [Second surgery in the management of ovarian cancer].
abstract: The aim of this study was to evaluate the value of second surgery in the combined and multidisciplinary treatment of mullerian ovarian cancer. A retrospective study was carried out in 86 consecutive patients with advances stages of mullerian ovarian cancer (stage 3-4) referred to the Division of Gynecological Surgical Oncology of the Oncological Reference Centre at Aviano for continuation of treatment following initial surgery and chemotherapy performed in various peripheral institutions. Second surgery only revealed 11.6% of complete endocelomatic pathological responses (10 patients) to earlier treatments; among the 76 patients with persistent disease it was possible to achieve optimal redebulking in 50 (65.8%) (31 R0 and 19 R1 after second surgery), whereas it was not possible to perform adequate second surgery in 26 (34.2%). The impact of second surgery on the probability of survival (mean survival rate) was highly significant in the 50 patients in whom it was possible to perform adequate second surgery compared to the non-operated group (14.34 months versus 6.10, chi square = 12.671, p = 0.0004). The authors underline both the prognostic value of lymph node status with increased mortality among patients with positive retro-peritoneal lymph nodes (LN+), and the value of retroperitoneal re-evaluation in predicting endo-peritoneal recidivation in patients with free abdomen who subsequently relapsed.
authors.affiliation: Divisione di Oncologia Ginecologica, Centro di Riferimento Oncologico, Aviano, PN.
authors.forename: C
authors.initials: C
authors.lastname: Scarabelli
authors.forename: E
authors.initials: E
authors.lastname: Campagnutta
authors.forename: A
authors.initials: A
authors.lastname: Zarrelli
authors.forename: G
authors.initials: G
authors.lastname: De Piero
authors.forename: F
authors.initials: F
authors.lastname: Sopracordevole
authors.forename: M C
authors.initials: MC
authors.lastname: Visentin
authors.forename: G
authors.initials: G
authors.lastname: Giorda
authors.forename: G M
authors.initials: GM
authors.lastname: Sasso
authors.forename: A
authors.initials: A
authors.lastname: Parin
authors.forename: A
authors.initials: A
authors.lastname: Gallo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000145:classification / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D010052:Ovariectomy / Q000379:methods; D012086:Reoperation; D015996:Survival Rate
vernacular_title: La seconda chirurgia nel trattamento del cancro ovarico.