title: Bowel resection at the time of primary debulking for epithelial ovarian carcinoma: outcomes in patients treated with platinum and taxane-based chemotherapy.
abstract: BACKGROUND
  Our goal was to determine the morbidity, disease-free survival, and overall survival of patients with bowel resection at primary cytoreductive surgery for advanced epithelial ovarian carcinoma in the era of platinum and taxane chemotherapy.
  
  
  METHODS
  We performed a retrospective study of patients undergoing bowel resection at the time of primary cytoreduction for advanced epithelial ovarian carcinoma, who subsequently received platinum and taxane chemotherapy, from 1996 to 2001. Data collected included demographics, stage, histology, debulking status, surgical morbidity, recurrence, and survival. Survival analysis and comparisons were performed using the Kaplan-Meier method and log-rank test.
  
  
  RESULTS
  Of 48 patients (45 stage III; 3 stage IV), 25 patients (52%) were optimally debulked to < 1 cm of residual disease; the remaining 23 patients had residual disease > 1 cm. Four-year disease-free survival in the optimally debulked group was 24% versus 12% in the suboptimally debulked group (p=0.009). Four-year overall survival was 81% in the optimally debulked group versus 54% in the suboptimally debulked group (p=0.162). Five patients (10%) experienced a major postoperative complication including stroke, small bowel obstruction, anastomotic leak, entercutaneous fistula, and pelvic abscess. Two perioperative deaths occurred in the suboptimally debulked group.
  
  
  CONCLUSIONS
  Patients with advanced epithelial ovarian carcinoma who undergo bowel resection as part of optimal cytoreduction and receive platinum and taxane chemotherapy have improved disease-free survival and a trend toward improved overall survival. Bowel resection at the time of primary cytoreductive surgery is associated with acceptable perioperative morbidity.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama-Birmingham, 619 19th Street South, Birmingham, AL 35249-7333, USA.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Estes
authors.forename: Charles A
authors.initials: CA
authors.lastname: Leath
authors.forename: J Michael
authors.initials: JM
authors.lastname: Straughn
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Rocconi
authors.forename: Tyler O
authors.initials: TO
authors.lastname: Kirby
authors.forename: Warner K
authors.initials: WK
authors.lastname: Huh
authors.forename: Mack N
authors.initials: MN
authors.lastname: Barnes
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007422:Intestines / Q000601:surgery*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery*; D017671:Platinum Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds; D043823:Taxoids