Abstract
Objective
The aim of the study was to determine the impact of rectosigmoid resection, at the
time of primary cytoreductive surgery, on morbidity and survival of patients with
advanced ovarian cancer.
Methods
We performed a retrospective medical chart review of patients who underwent rectosigmoid
resection for ovarian, tubal and peritoneal cancers between 1998 and 2008 at the IEO
in Milan and JHMI in Baltimore. Perioperative and follow-up data were collected.
Results
A total of 238 patients were identified; 180 (75%) had stages IIC–IIIC and 58 (25%)
had stage IV. Complete cytoreduction was achieved in 41% of the cases. Stapled coloproctostomy
was performed in 98% while hand sewn in only 2%; a protective ileostomy and colostomy
were necessary (constructed) in 2 (0.8%) and 5 (2%) cases respectively. The complications
associated to rectosigmoid resection were anastomotic leakage in 7 (3%) patients and
pelvic abscess in 9 (3.7%). Fifty percent of patients recurred during the study period,
but only 5% of them showed a relapse at the level of the pelvis whereas 8% presented
with abdominal recurrence associated with pelvic disease as well. The median overall
survival time among patients with complete cytoreduction was 72 months compared with 42 months among the rest of patients (p=0.002).
Conclusions
Rectosigmoid colectomy may significantly contribute to achieve a complete primary
cytoreduction for advanced stage ovarian, tubal and peritoneal cancers. Pelvic complete
debulking accomplished by rectosigmoid resection could be associated with a lower
rate of pelvic recurrence as well.
Highlights
- Rectosigmoid colectomy can contribute significantly to a maximal cytoreductive surgical effort for recurrent ovarian cancer.
- Pelvic complete debulking accomplished by rectosigmoid resection seems to be associated with a significant lower rate of pelvic recurrence.
Keywords
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Article info
Publication history
Accepted:
April 23,
2012
Received:
January 24,
2012
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
