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Primary cytoreductive surgery with rectosigmoid colon resection for patients with advanced epithelial ovarian carcinoma

  1. Carlo Scarabelli M.D.1,*,
  2. Angelo Gallo M.D.1,
  3. Silvia Franceschi M.D.2,
  4. Elio Campagnutta M.D.1,
  5. Giovanni De Piero M.D.1,
  6. Giorgio Giorda M.D.1,
  7. Maria Caterina Visentin M.D.1,
  8. Antonino Carbone M.D.3

Article first published online: 20 NOV 2000

DOI: 10.1002/(SICI)1097-0142(20000115)88:2<389::AID-CNCR21>3.0.CO;2-W

Issue

Cancer

Cancer

Volume 88, Issue 2, pages 389–397, 15 January 2000

Additional Information

How to Cite

Scarabelli, C., Gallo, A., Franceschi, S., Campagnutta, E., De Piero, G., Giorda, G., Visentin, M. C. and Carbone, A. (2000), Primary cytoreductive surgery with rectosigmoid colon resection for patients with advanced epithelial ovarian carcinoma. Cancer, 88: 389–397. doi: 10.1002/(SICI)1097-0142(20000115)88:2<389::AID-CNCR21>3.0.CO;2-W

Author Information

  1. 1

    Division of Gynecologic Oncology, Centro di Riferimento Oncologico di Aviano, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico; Aviano, Italy

  2. 2

    Division of Epidemiology, Centro di Riferimento Oncologico di Aviano, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico; Aviano, Italy

  3. 3

    Division of Pathology, Centro di Riferimento Oncologico di Aviano, Istituto Nazionale di Ricovero e Cura a Carattere Scientifico, Aviano, Italy

*Division of Gynecologic Oncology, Centro di Riferimento Oncologico di Aviano, Via Pedemontana Occidentale no. 12, 33081 Aviano (PN), Italy

Publication History

  1. Issue published online: 20 NOV 2000
  2. Article first published online: 20 NOV 2000
  3. Manuscript Revised: 23 SEP 1999
  4. Manuscript Accepted: 23 SEP 1999
  5. Manuscript Received: 25 MAR 1999

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Keywords:

  • ovarian carcinoma;
  • cytoreductive surgery;
  • bowel surgery;
  • survival

Abstract

BACKGROUND

The impact of radical bowel resection with multiple organ resection on the survival if patients with advanced ovarian carcinoma has not been well defined. The authors investigated whether primary cytoreductive surgery including rectosigmoid colon resection would affect the recurrence free interval and survival of these patients.

METHODS

Between April 1990 and April 1997, 66 previously untreated Stage IIIC–IV ovarian carcinoma patients with macroscopic involvement of the rectosigmoid colon were enrolled. All patients underwent cytoreductive surgery with rectosigmoid colon resection to remove residual tumor less than 2 cm in greatest dimension and received 6 cycles of cisplatin-based postoperative chemotherapy.

RESULTS

The median follow-up was 26 months (range, 7–104 months). In multivariate analysis, residual disease and depth of tumor infiltration of the bowel wall were independently associated with overall survival and recurrence free interval. Disease stage was independently associated only with overall survival. Residual tumor was the most strongly predictive factor for recurrence or death. The 2-year estimated survival rates according to the amount of residual tumor were 100% for 24 patients with no macroscopic residual disease and 77.3% for 28 patients with residual disease less than 1 cm. None of the 14 patients with residual disease larger than 1 cm were alive 2-years after operation. Overall, 48 patients (72.7%) developed disease recurrence: 43 (65.1%) in the abdomen, 19 (29.8%) in the liver, and 3 (4.5%) in the pelvis.

CONCLUSIONS

The current findings suggest that cytoreductive surgery with rectosigmoid colon resection should be considered for ovarian carcinoma patients with bulky pelvic disease to help ensure that they are left with no residual disease after debulking surgery. Cancer 2000;88:389–97. © 2000 American Cancer Society.

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