Surgical treatment and prognosis in patients with intestinal metastases originated from advanced epithelial ovarian cancer.

OBJECTIVE

To analyze the surgical treatment and prognosis of patients with advanced epithelial ovarian cancer with intestinal metastases.

METHODS

A retrospective study was conducted on 255 patients diagnosed with epithelial ovarian cancer stage III or IV with bowel metastases between January 1st, 2015 and December 31st, 2020, divided into two groups, the study group was the bowel resection group (101 cases), and the control group was the bowel tumor stripping group (154 cases).

RESULTS

R0 rate reached 75.4% in this cohort study. Patients in the bowel resection group were more likely to be in stage IV and had higher surgical complexity scores (P=0.021). The incidence of intraoperative blood transfusion, pneumonia and pleural effusion was significantly lower in the bowel tumor stripping group than in the bowel resection group. The rate of anastomotic fistula was 1.98% in the bowel resection group and 0% in the tumor-stripping group. It was similar between groups in terms of 5-year overall survival (OS) and 5-year progression free survival (PFS), 65.8% vs 73.8%, 70.6% vs 80.3%. 5-year OS was similar between the tumor stripping group with only residual lesions in the bowel wall and the bowel resection group, but 5-year PFS was significantly higher in the bowel resection group (P=0.032). No matter what PDS or IDS was used, 5-year OS and 5-year PFS were similar in both groups after cytoreductive surgery reached R0.

CONCLUSION

Bowel tumor stripping does not negatively affect the prognosis of advanced ovarian cancer if R0 cytoreductive surgery is achieved. Excessive bowel resection does not improve overall survival.