Aggressive regional surgery for advanced ovarian carcinoma

✍ Scribed by Henri Joyeux; Bernard Saint-Aubert; Mustapha M. Elazhary; Claude Solassol; Henri Pujol; Andrew W. Szawlowski

• Publisher: John Wiley and Sons
• Year: 1986
• Tongue: English
• Weight: 570 KB
• Volume: 57
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19860101)57:1<142::aid-cncr2820570129>3.0.co;2-#

✦ Synopsis

RS) was performed on 18 Stage 111 and 3 Stage IV patients (International Federation of Gynecology and Obstetrics [FIGOJ) with histologically proven cystadenocarcinoma of the ovary. All patients were placed into one of three nonrandomized groups: Group A (9 patients), R S a t first-look surgery; Group B (7 patients), RS at second-look surgery; and Group C (5 patients), RS at third-look surgery. Group A was given adjuvant chemotherapy, whereas Group B and C patients underwent nonregional surgery at firstor second-look operation, and received chemotherapy supplemented in some Group C cases by radiotherapy before RS. The adjuvant chemotherapy consisted of: cyclophosphamide plus Alkeran (mephalan) plus 5fluorouracil (the first 7 patients) and Adriamycin (doxorubicin) plus cisplatin plus hexamethylmelamine (14 additional patients). RS consisted of basic procedures-abdominal hysterectomy; bilateral salpingooophorectomy; omentectomy-and specific procedures-abdominal and pelvic peritonectomy; either total or partial colectomy; jejunoilectomy, leaving at least 150 cm of the jejunum; and retroperitoneal lymph node dissection aimed at maximal cytoreduction of tumor mass. There was no operative mortality. The overall postoperative morbidity waf 33.3% (seven patients) due to wound sepsis. The survival from the beginning of treatment (absolute survival [AS]) and survival after RS (RSS) were compared. In Group A ( A S = RSS) the probability of survival at 112 months (6/9 patients are still alive) was 0.52. In Groups B and C the median survival times (AS and RSS) were 37 and 17 months and 18 and 1 month, respectively. The difference in AS among the three groups of patients was not statistically significant (log-rank test), whereas the RSS was statistically significant between Group A versus Groups B, C, and Groups B and C combined (P < 0.05).