An Analysis of Long-Term Outcomes in Patients Treated by Extensive Bowel Resection Due to Advanced Ovarian Cancer Relative to the Effectiveness of Surgery

Gynecol Obstet Invest. 2020;85(2):159-166. doi: 10.1159/000504538. Epub 2019 Nov 20.

Abstract

Introduction: Surgery for advanced ovarian cancer (AOC) often requires bowel resections. However, the impact of bowel surgery on patient overall survival (OS) has not yet been precisely determined.

Objective: The aim of the study was to analyze the OS rates in a group of AOC patients undergoing bowel resection.

Methods: We carried out a retrospective analysis of patients who had undergone low anterior resection of the rectum (LAR) during primary or interval debulking surgery for AOC. We divided the patients into 2 groups: Group 1 included 69 patients who underwent only LAR; Group 2 included 66 patients who underwent LAR and additional bowel resection. The control group included 71 AOC patients who did not required bowel resection.

Results: In the subgroup of patients with no gross residual disease (NGR), there were no differences in OS between Groups 1 and 2. In the subgroup of "optimally" (tumors <1 cm) debulked patients, Group 1 patients had a higher median OS than Group 2 patients. Additionally, there was no difference between Groups 1 and 2 as far as the number of severe adverse events.

Conclusions: Multiple bowel resections seem to improve OS in patients when NGR is achieved but should be avoided when complete resection is not possible.

Keywords: Advanced ovarian cancer; Bowel resection; Cytoreductive surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Cytoreduction Surgical Procedures / methods
  • Cytoreduction Surgical Procedures / mortality*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm, Residual
  • Ovarian Neoplasms / mortality*
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Proctectomy / methods
  • Proctectomy / mortality*
  • Rectum / pathology
  • Rectum / surgery
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome