Total colectomy as part of primary cytoreductive surgery in advanced Müllerian cancer.
OBJECTIVE
To investigate morbidities and surgical outcomes of total colectomy conducted during primary cytoreductive surgery in advanced Müllerian cancer.


METHODS
The authors reviewed the medical records of 22 patients with stage IIIC or IV advanced Müllerian cancer that underwent total colectomy at the National Cancer Center Korea between January 2003 and December 2007.


RESULTS
Total colectomy was performed in 22 patients, of whom 2 (9.1%) underwent prophylactic ileostomy and 1 (4.5%) permanent ileostomy. Optimal cytoreduction (residual tumor <1 cm) was possible in 20 patients (90.9%). Median times at passage of flatus and initiation of tolerable diet were days 4 (2-10) and 6 (4-18) postoperatively, respectively. Nine postoperative morbidities, not directly related to ileo-rectal anatomosis, occurred in 7 patients (31.8%) and were successfully managed conservatively. No fistula developed during a mean follow-up of 16 months (range, 2-56). There was no surgery-related mortality. Diarrhea after total colectomy was well managed by medical treatment in most patients. Median time to recovery to previous bowel habits was 12 months (range, 6-20) in the 11 patients evaluable. Five-year progression free survival and overall survival rates were 38.6% and 74.4%, respectively.


CONCLUSIONS
Total colectomy is a feasible and safe procedure in terms of minimizing residual tumor in most patients with advanced Müllerian cancer with acceptable morbidities.
Song
Yong Jung
YJ
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do 410-769, Republic of Korea.
Lim
Myong Cheol
MC
Kang
Sokbom
S
Seo
Sang-Soo
SS
Park
Ji Won
JW
Choi
Hyo Seong
HS
Park
Sang-Yoon
SY
D000328:Adult; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D005185:Fallopian Tube Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018200:Mixed Tumor, Mullerian / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies