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Operative results after primary and secondary debulking-operations in advanced ovarian cancer (AOC)
W Lichtenegger1, J Sehouli, E Buchmann
1Department of Gynaecology, Charité/Campus Virchow Hospital, Medical Faculty of the Humboldt-University, Berlin, Germany.
Objective:
To assess the role of primary and secondary radical surgery in advanced ovarian cancer (AOC).
Design:
Retrospective study.
Methods:
One hundred and fifty-one patients with AOC (FIGO III/IV) underwent altogether 191 extended multivisceral operations between 1/1992 and 2/1998. The statistic analysis compared the primary with the secondary operations.
Results:
One hundred and seventeen patients had a primary, 63 patients had a secondary and 18 patients a tertiary operation because of relapse of ovarian cancer. Surgical procedures entailed respectively: small-bowel-resection (21%/48%), colon resection (39%/58%), colostomy (9%/11%), ileostomy (2%/4%), ileum-pouch (0%/6), splenectomy (3%/3%), pelvic floor-covering (4%/6%), peritoneal removal (24%/21%), infrared contact coagulation (4%/6%). Seventy-five percent of the patients had no complications: relaparotomy (3%/3%), fistula (3%/6%), short-bowel-syndrome (5%/11%), postoperatively mortality (2%/6%). Postoperative tumor-free were 26%/22%, 57% and 65% had residual disease < or = 2 cm, 16%/13% > 2 cm.
Conclusions:
Radical multivisceral surgery is feasible, safe and efficient in primary as well in secondary situation of advanced ovarian cancer.