title: Total rectosigmoidectomy versus partial rectal resection in primary debulking surgery for advanced ovarian cancer.
abstract: OBJECTIVE
  To compare in a sample of Italian patients intraoperative, perioperative complications, Quality of Life (QoL), recurrence rate and overall survival of advanced ovarian cancer (AOC) patients according to the type of surgery performed on sigma-rectum, total rectosigmoid resection (TRR) versus partial rectosigmoid resection (PRR).
  
  
  METHODS
  From May 2004 to May 2010, consecutive patients affected by epithelial AOC (FIGO Stage III-IV) were assessed for this prospective case-control study, According to the type of colorectal surgery performed to approach rectosigmoid involvement, patients were allocated into Group A (TRR) and Group B (PRR). PRR was performed when the complete removal of disease led to a laceration <30-40% of intestinal wall circumference.
  
  
  RESULTS
  82 and 72 patients were included in Group A and Group B respectively. Surgical outcomes were statistically similar except hospital stay which was significantly lower in the PRR group. There was not a statistically significant difference as regarding intra-operative, perioperative and postoperative complications, even if a higher rate of major complications were recorded in TRR. An improvement in QoL's scores has been recorded in PRR's group. There was not a statistically difference concerning the optimal debulking rate (92% and 96% respectively) and 5-year Overall Survival (48% and 52% respectively).
  
  
  CONCLUSIONS
  PRR seems to be feasible in over 40% of patients with advanced ovarian cancer and recto-sigmoid colon involvement. It is related to higher QoL and can be easily performed, without jeopardizing surgical radicality, in those cases in which conservative surgery at intestinal tract does not compromise residual tumor.
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Plotti
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy; Unit of Obstetrics and Gynecology, Magna Graecia University of Catanzaro, Italy. Electronic address: rmontera@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Montera
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Aloisi
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scaletta
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Capriglione
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Luvero
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Cicco Nardone
authors.affiliation: Unit of Obstetrics and Gynecology, Pisa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Basile
authors.affiliation: Institute of Gynecology, Perinatology and Child Health, La Sapienza University, Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Benedetti Panici
authors.affiliation: Department of Obstetrics and Gynaecology, Campus Bio-Medico University of Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Angioli
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods / Q000401:mortality; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000556:secondary / Q000601:surgery; D007558:Italy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D011379:Prognosis; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Bowel surgery; Ovarian cancer; Primary debulking surgery; Quality of life