Surgery at primary versus relapsed epithelial ovarian cancer: a study on aspects of anaesthesiological management.
BACKGROUND
Primary cytoreductive surgery (CS) for epithelial ovarian cancer (EOC) is well-established. CS at relapse remains controversial, with an unclear morbidity profile.


METHODS
We analyzed 121 patients with EOC who underwent CS. Two groups were identified by timing of surgery due to primary disease and due to recurrent disease.


RESULTS
CS for primary versus recurrent EOC led to no differences in haemodynamic management, such as transfusion rates, application of vasopressors, ICU and hospital length of stay, or mortality. The risk for postoperative ileus was higher in patients with relapsed versus primary EOC. This might be attributed to patients being operated due to preoperative ileus and a higher small bowel resection rate at CS for relapse.


CONCLUSIONS
CS for EOC relapse does not seem to be more challenging in terms of perioperative management compared to that at initial diagnosis. The major surgical morbidity profile was comparable apart from a higher risk for postoperative ileus at relapse.
Department of Anaesthesiology and Intensive Care Medicine, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany aarne.feldheiser@charite.de.
Aarne
A
Feldheiser
Department of Anaesthesiology and Intensive Care Medicine, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Anne Bar
AB
Yosef
Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Elena-Ioana
EI
Braicu
Department of Anaesthesiology and Intensive Care Medicine, Hospital Luigi Sacco, Milan, Italy.
Tommaso
T
Bonomo
Department of Anaesthesiology and Intensive Care Medicine, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Lutz
L
Kaufner
Department of Anaesthesiology and Intensive Care Medicine, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Claudia
C
Spies
Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Jalid
J
Sehouli
Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, U.K.
Christina
C
Fotopoulou
Department of Gynaecology, European Competence Center for Ovarian Cancer, Charité-University Medicine Berlin, Berlin, Germany.
Klaus
K
Pietzner
D000758:Anesthesia / Q000379:methods*; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology
Ovarian cancer; cytoreductive surgery; haemodynamic management; postoperative morbidity; relapse; transfusion