title: Results of optimal debulking surgery with bowel resection in patients with advanced ovarian cancer.
abstract: BACKGROUND
  The surgical treatment of patients with advanced-stage ovarian cancer is based on maximal cytoreduction with widening the debulking on the extra-ovarian tissues and infiltrated organs. The purpose of the study was to assess the outcome after optimal cytoreduction with partial bowel resection and to find the risk factors of relapse. Another goal was the quantitative and qualitative assessment of intra- and postoperative complications in the studied group.
  
  
  METHODS
  The analysis of debulking procedures with intestinal resection and postoperative period in 33 ovarian cancer patients, The International Federation of Gynecology and Obstetrics (FIGO) stages III and IV, was performed.
  
  
  RESULTS
  The optimal cytoreduction defined as less than 1.0 cm residual disease was achieved in all patients including the following: 26 patients (78.8%) with no macroscopic residual disease, 4 patients (12.1%) with the largest residual tumor less than 0.5, and 3 patients (9.1%) with 0.5 cm to less than 1.0 cm residual disease. The rectosigmoid resection was the most common surgical procedure (n = 27). The risk of relapse was significantly higher in subjects who had the macroscopic residual tumor left during the primary operation (57.1 vs. 11.5%, P = 0.035). A primary bowel tumor size was another predictor of relapse. The maximum tumor diameter was significantly larger (14.9 ± 6.7 cm vs. 10.3 ± 4.7 cm, P = 0.047) in patients who developed the relapse.
  
  
  CONCLUSIONS
  As presented in the article, our outcomes and other authors' observations indicate that debulking surgery with bowel resection in patients with advanced ovarian cancer brings good results. Complications connected with bowel surgery are to be accepted. The interesting thing is that a primary bowel tumor size was a predictor of relapse.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St, 00-315, Warsaw, Poland. derlatek@gmail.com.
authors.forename: Pawel
authors.initials: P
authors.lastname: Derlatka
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St, 00-315, Warsaw, Poland. jacek.sienko@wum.edu.pl.
authors.forename: Jacek
authors.initials: J
authors.lastname: Sienko
authors.affiliation: 2nd Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland. larettagrabowska@gmail.com.
authors.forename: Laretta
authors.initials: L
authors.lastname: Grabowska-Derlatka
authors.affiliation: 2nd Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland. sounded@wp.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Palczewski
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St, 00-315, Warsaw, Poland. ad.bidzinska@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Danska-Bidzinska
authors.affiliation: The Faculty of Health Science, The Jan Kochanowski University in Kielce, Kielce, Poland. bidzinski.m@gmail.com.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Bidzinski
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St, 00-315, Warsaw, Poland. krzysztof.czajkowski@wum.edu.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Czajkowski
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000601:surgery*; D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery*; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures; D013505:Digestive System Surgical Procedures; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis