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Prognostic Value of En-Block Radical Bowel Resection in Advanced Ovarian Cancer Surgery With HIPEC
T Panoskaltsis1,2, C Papadimitriou3, N Pallas2
1Gynaecological Oncology Unit, 2nd Academic Department of Obstetrics and Gynaecology, Aretaieion Hospital, 68989The National and Kapodistrian University of Athens, Athens, Greece.
Cancer Control : Journal of the Moffitt Cancer Center
|March 23, 2023
Summary
Radical surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in advanced ovarian cancer. Metastatic bowel lymph nodes significantly impact recurrence and survival, highlighting the importance of thorough lymphadenectomy.
Area of Science:
- Surgical Oncology
- Gynecologic Oncology
- Cytoreductive Surgery
- Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Background:
- Advanced ovarian cancer presents significant challenges for treatment and prognosis.
- Radical surgery combined with HIPEC is explored as a therapeutic strategy.
- Identifying prognostic factors is crucial for improving patient outcomes.
Purpose of the Study:
- To identify prognostic factors for survival and recurrence in advanced ovarian cancer patients.
- To evaluate the role of radical surgery and HIPEC in managing these patients.
Main Methods:
- Retrospective analysis of 152 advanced ovarian cancer patients undergoing complete (CC-0) or near-complete (CC-1) cytoreduction and HIPEC.
- Inclusion criteria involved radical surgery with at least one colonic resection.
- Data analysis included univariate and multivariate assessments of prognostic factors.
Main Results:
- Complete cytoreduction (CC-0) was achieved in 72.4% of patients.
- Five- and 10-year survival rates were 43% and 36.2%, respectively, with a recurrence rate of 35.5%.
- Advanced age, extensive peritoneal dissemination, low lymph node yield, and metastatic large bowel lymph nodes were associated with poor survival and recurrence.
Conclusions:
- Complete cytoreduction (CC-0) is feasible in most advanced ovarian cancer patients.
- HIPEC may offer a survival benefit, and radical bowel resection is essential.
- Metastatic bowel lymph nodes significantly influence disease recurrence and survival, underscoring their importance in treatment assessment.
