MULTIPLE INTERVAL DEBULKING SURGERY IN RECURRENT UTERINE SARCOMA (CASE REPORT)

We report a case of a 61-year-old woman, who had been suffering from multiple relapses of uterine sarcoma treated by multiple cytoreduction operations. During the observation period there were performed 13 surgical interventions. As a result of operations, together with the removal of more than 60 liters of tumor volume, the following were performed: extirpation of the uterus with ovaries, right colectomy, resection of the small intestine four times, resection of the sigmoid colon, resection of the duodenum, peritonectomy, cholecystectomy, appendectomy, 2 cycles of adjuvant chemotherapy and Hyperthermic intraperitoneal chemotherapy procedure. During this entire period, with interruptions for hospital treatment, the patient works as a teacher, quality of life remains satisfactory. Patient observation continues, according to the computed tomography control (last time 02.12.2021) there are no signs of tumor relapse. 64 months have passed since the first clinical relapse. The overall survival rate is 69 months and it has already exceeded the theoretically unattainable 5 years from the onset of the disease. Cytoreductive surgery in patients with chemo- and radioresistant tumors of the abdominal cavity is the only effective method of treatment of this group of patients in addition to symptomatic therapy. Repeated early optimal cytoreduction with the maximum possible removal of all detected tumor mass and restoration of anatomical or functional integrity of the affected organs can reduce the likelihood of tumor cachexia, intoxication, anemia, thrombosis and hemorrhage, edema and dysfunction of the digestive and urinary systems. This prolongs life expectancy and increases its quality in patients with second and more uterine sarcoma relapse.