Splenectomy in recurrent epithelial ovarian cancer.
OBJECTIVE
To report a series of patients with recurrent epithelial ovarian cancer who underwent splenectomy for isolated parenchymal metastases.


METHODS
We performed a retrospective review of all patients who had a splenectomy for ovarian cancer at our institution during the period 1991 to 1997.


RESULTS
Six patients were identified who had a splenectomy performed for recurrent epithelial ovarian cancer confined to the splenic parenchyma. All had initial cytoreductive surgery for Stage III disease followed by platinum-based chemotherapy. Five patients underwent second-look surgery and four of them had pathologically confirmed persistent disease. All five patients who underwent second-look surgery had an intraperitoneal (ip) port placed and received platinum-based ip chemotherapy. Computed tomography (CT) scan performed during the posttreatment surveillance period demonstrated recurrent disease confined to the spleen in all six patients. Splenectomy was performed at a median of 57 months (range 28-88 months) after the initial surgery. The only major complication was a diaphragmatic tear necessitating chest tube placement. With a median follow-up of 25.5 months (range 6-65 months), all six patients are alive and free of disease.


CONCLUSIONS
Splenectomy is a safe and feasible procedure in recurrent epithelial ovarian cancer. Isolated parenchymal splenic metastasis may occur as a late recurrence in epithelial ovarian cancer and splenectomy should be considered a part of the management of this group of patients.
Gynecology Service Academic Office, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021, USA.
M L
ML
Gemignani
D S
DS
Chi
C C
CC
Gurin
J P
JP
Curtin
R R
RR
Barakat
D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013156:Splenectomy / Q000379:methods; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome