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The place of bowel resection in initial debulking surgery for advanced ovarian cancer
John Miller1, Anthony Proietto
1Queensland Centre for Gynaecological Cancer, Royal Women's Hospital, Brisbane, Queensland, Australia.
Objective:
To evaluate the efficacy and morbidity associated with bowel resection at the initial debulking procedure for patients with advanced ovarian cancer.
Design:
Retrospective medical record and computerised database review.
Setting:
John Hunter Hospital, Newcastle, New South Wales.
Sample:
All women with FIGO stage III or IV epithelial ovarian cancer and with adequate case note documentation who underwent bowel resection as part of their primary debulking surgery at the John Hunter Hospital from 1991 to July 2000.
Main Outcome Measures:
Cumulative overall and disease free survival, optimal (residual disease < 1 cm) versus suboptimal cytoreduction and short (< 6 weeks) and long-term postoperative morbidity.
Results:
For the optimally debulked patients the two and five-year overall and disease free survival rates were 49%, 30%, 19% and 8.9% respectively. The two-year overall survival rate for the suboptimally debulked patients was 20%. The major short-term morbidity rate was 17.6%. Long-term morbidity occurred in 10 of 51 patients; however, not all morbidity was surgery related.
Conclusions:
Cytoreductive surgery, including bowel resection, appears indicated in the treatment of patients with advanced ovarian cancer. The surgical morbidity rate from these procedures appears acceptable.
