Surgical indications for combined partial rectosigmoidectomy in ovarian cancer
Article first published online: 22 NOV 2005
Journal of Obstetrics and Gynaecology Research
Volume 31, Issue 6, pages 556–561, December 2005
How to Cite
Takahashi, O., Sato, N., Miura, Y., Ogawa, M., Fujimoto, T., Tanaka, H., Sato, H. and Tanaka, T. (2005), Surgical indications for combined partial rectosigmoidectomy in ovarian cancer. Journal of Obstetrics and Gynaecology Research, 31: 556–561. doi: 10.1111/j.1447-0756.2005.00336.x
- Issue published online: 22 NOV 2005
- Article first published online: 22 NOV 2005
- Received: February 18 2005. Accepted: July 8 2005.
- bowel resection;
- ovarian cancer;
Aim: To evaluate surgical indications for combined partial rectosigmoidectomy in ovarian cancer with direct invasion of the rectum and sigmoid colon or dissemination into the pouch of Douglas.
Methods: Subjects comprised 25 patients with ovarian cancer who underwent primary surgery and rectosigmoidectomy between 1990 and 2002 at our hospital. Federation of Obstetrics and Gynecology staging of tumors was II (n = 6), III (n = 17) or IV (n = 2). The histologic type was serous adenocarcinoma (n = 18), clear cell adenocarcinoma (n = 4), and others (n = 3). Bowel resection was performed during primary surgery in 18 patients, and after neoadjuvant chemotherapy (NAC) in seven patients. Cumulative survival rate was compared between NAC and non-NAC groups. Patients were divided into three groups based on extent of surgical resection to compare survival rates: no residual tumor (n = 19); maximum residual tumor diameter <1 cm (n = 5); and maximum residual tumor diameter ≥1 cm (n = 1).
Results: Cumulative 5-year survival was 41.3% for all patients. Cumulative 5-year survival in the 18 patients who underwent bowel resection during primary surgery was 62.2%, compared to 13.9% in the seven patients who underwent bowel resection after NAC. Cumulative 5-year survival based on extent of surgical resection was: no residual tumor, 60.8%; residual <1 cm, 0%; and residual ≥1 cm, 0%. Cumulative 5-year survival for patients with complete tumor resection (no residual tumor), excluding clear cell adenocarcinoma, was 79.5%.
Conclusion: In ovarian cancer with direct invasion of the rectum or sigmoid colon or dissemination into the pouch of Douglas, complete tumor resection with rectosigmoidectomy during primary surgery is associated with good clinical outcomes.