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Modified posterior exenteration for ovarian cancer
S M Eisenkop1, R H Nalick, N N Teng
1Center for Gynecologic Oncology, Encino, California.
Obstetrics and Gynecology
|November 1, 1991
Summary
Modified posterior exenteration effectively removes advanced ovarian cancer pelvic disease. This cytoreductive surgery offers patients with advanced disease optimal treatment and improved survival chances.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Ovarian Cancer Research
Background:
- Advanced epithelial ovarian cancer (stage IIIC/IV) often presents with extensive pelvic disease.
- Pelvic disease encasing reproductive organs, peritoneum, cul-de-sac, and sigmoid colon poses significant surgical challenges.
- Cytoreductive surgery is crucial for managing advanced ovarian cancer.
Purpose of the Study:
- To describe the operative details and outcomes of modified posterior exenteration in advanced ovarian cancer patients.
- To evaluate the efficacy of this surgical approach in achieving cytoreduction and its impact on patient survival.
- To assess morbidity and mortality associated with the procedure.
Main Methods:
- Retrospective review of 47 patients with stage IIIC or IV epithelial ovarian cancer undergoing modified posterior exenteration.
- Detailed analysis of operative findings, additional cytoreductive procedures, postoperative course, and follow-up data.
- Assessment of cytoreduction completeness (optimal vs. complete) and fecal continence.
Main Results:
- Modified posterior exenteration was performed in 47 patients (37 primary, 10 secondary cytoreduction).
- 95.7% achieved optimal cytoreduction (<2 cm), and 38.3% achieved complete cytoreductive surgery.
- 38.3% experienced serious morbidity, and 2.1% had postoperative mortality. Fecal continence was achieved in 72.3% of patients.
Conclusions:
- Modified posterior exenteration is an effective surgical technique for removing all visible pelvic disease in advanced ovarian cancer.
- The procedure is associated with acceptable mortality and morbidity, enabling optimal cytoreduction.
- This approach can render patients with advanced ovarian cancer suitable for adjunctive therapy, potentially improving survival or offering a chance for cure.