Prognostic role of bowel involvement in optimally cytoreduced advanced ovarian cancer: a retrospective study

Journal of Ovarian Research

Elio Campagnutta⁵  Gustavo Baldassarre⁴  Andrea Tinelli⁶  Francesco Sopracordevole⁵  Valentina E Bounous²  Roberto Sorio³  Emilio Lucia⁵  Angiolo Gadducci¹  Giorgio Giorda⁵ 

[1] Departement of Clinical and Experimental Medicine, Division of Gynecology and Obstetric University of Pisa, via. Roma 67, I- 56126 Pisa, (PI), Italy;Academic Division of Gynecology and Obstetrics “Umberto I” Hospital University of Turin, Via Magellano 1, I- 10128 Torino, Italy;Department of Medical Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute, via Gallini 2, I-33019 Aviano, (PN), Italy;Division of Experimental Oncology 2 of Centro di Riferimento Oncologico (CRO) National Cancer Institute, via Gallini 2, I-33019 Aviano, (PN), Italy;Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute, via Gallini 2, I-33019 Aviano, (PN), Italy;Obstetric and Gynecologic Departement, Hospital V. Fazzi, Piazza F. Muratore, Snc - 73100 Lecce, (Le), Italy

关键词: Grading;    Bowel surgery;    Debulking surgery;    Bowel involvement;    Advanced ovarian cancer;   

Others  :  1151826
DOI  :  10.1186/1757-2215-7-72

 received in 2014-02-10, accepted in 2014-06-26,  发布年份 2014

【 摘 要 】

Background

Optimal debulking surgery is postulated to be useful in survival of ovarian cancer patients. Some studies highlighted the possible role of bowel surgery in this topic. We wanted to evaluate the role of bowel involvement in patients with advanced epithelial ovarian cancer who underwent optimal cytoreduction.

Methods

Between 1997 and 2004, 301 patients with advanced epithelial cancer underwent surgery at Department of Gynecological Oncology of Centro di Riferimento Oncologico (CRO) National Cancer Institute Aviano (PN) Italy. All underwent maximal surgical effort, including bowel and upper abdominal procedure, in order to achieve optimal debulking (R < 0.5 cm). PFS and OS were compared with residual disease, grading and surgical procedures.

Results

Optimal cytoreduction was achieved in 244 patients (81.0%); R0 in 209 women (69.4.%) and R < 0.5 in 35 (11.6%). Bowel resection was performed in 116 patients (38.5%): recto-sigmoidectomy alone (69.8%), upper bowel resection only (14.7%) and both recto-sigmoidectomy and other bowel resection (15.5%). Pelvic peritonectomy and upper abdomen procedures were carried out in 202 (67.1%) and 82 (27.2%) patients respectively. Among the 284 patients available for follow-up, PFS and OS were significantly better in patients with R < 0.5. Among the 229 patients with optimal debulking (R < 0.5), 137 patients (59.8%) developed recurrent disease or progression. In the 229 R < 0.5 group, bowel involvement was associated with decreased PFS and OS in G1-2 patients whereas in G3 patients OS, but not PFS, was adversely affected. In the 199 patients with R0, PFS and OS were significantly better (p < 0.01) for G1-2 patients without bowel involvement whereas only significant OS (p < 0.05) was observed in G3 patients without bowel involvement versus G3 patients with bowel involvement.

Conclusions

Optimal cytoreduction (R < 0.5 cm and R0) is the most important prognostic factor for advanced epithelial ovarian cancer. In the optimally cytoreduced (R < 0.5 and R0) patients, bowel involvement is associated with dismal prognosis for OS both in patients with G1-2 grading and in patients with G3 grading. Bowel involvement in G3 patients, carries instead the same risk of recurrence for PFS.

【 授权许可】

   
2014 Giorda et al.; licensee BioMed Central Ltd.

【 图 表 】

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