The role of bowel surgery with cytoreduction for epithelial ovarian cancer.
OBJECTIVE
To assess the efficiency and morbidity associated with bowel resection with the initial cytoreduction procedure for advanced ovarian cancer.


METHODS
A review was carried of 95 patients with ovarian cancer who underwent cytoreductive surgery between 2000 and 2003. The relationship between dichotomised preoperative, intra-operative and postoperative outcome variables were tested using SPSS software. Kaplan-Meier curves were generated to compare survival. Cox proportional hazards regression was used to determine the independent significance of factors after cytoreductive surgery.


RESULTS
In patients in whom bowel resection was carried out, the largest residual tumour mass was <1cm in 66.67% of patients, compared with 45.28% of patients undergoing surgery without bowel resection (P=0.038). The median survival in the optimally debulked patients was 50.38 months compared with 37.15 months in the patients who had suboptimal cytoreduction (P=0.0021). The median survival in patients undergoing bowel resection was 50.70 months compared with 44.62 months in the patients who had cytoreduction without bowel resection (P=0.2176). Multivariate analysis showed that optimal cytoreduction (P=0.005) was found to be independently prognostic for overall survival. Major adverse events, such as ileus, intestinal fistulae, urinary tract fistulae, were not significantly different between groups.


CONCLUSIONS
Bowel resection is a worthwhile endeavour in selected patients with advanced ovarian cancer to increase therapeutic efficiency. The surgical morbidity rate from these procedures is not serious and seems acceptable.
Cai
H-B
HB
Department of Gynecological Oncology, Zhong Nan Hospital, Wuhan University, Wuhan 430071, China.
Zhou
Y-F
YF
Chen
H-Z
HZ
Hou
H-Y
HY
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007420:Intestine, Large / Q000601:surgery; D007421:Intestine, Small / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000150:complications*; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D012189:Retrospective Studies