Clinical Impact of a Surgical Energy Device in Advanced Ovarian Cancer Surgery Including Bowel Resection

The surgical treatment of advanced ovarian cancer is based on the maximal debulking with widening the operation range to the infiltrated organs. The aims are as follows: (1) the assessment of the quantity and quality of intra- and postoperative complications in patients with advanced ovarian cancer in which partial bowel resection was performed and (2) the evaluation of intra- and postoperative complications related to surgery with bowel resection and anastomosis, compared to Hartmann's procedure. The analysis of debulking procedures with intestinal resection and postoperative period in 39 ovarian cancer patients, FIGO stage III–IV, was performed. During 39 operations, the most frequent type of resection was the sigmoidectomy or proctosigmoidectomy (29 patients). In the remaining patients, left- and right-side hemicolectomy or partial enterectomy was done. Twenty-four anastomosis and 15 Hartmann's procedures were performed. There were no differences between surgery with anastomosis and Hartmann's procedure in aspect of quantity of complications, blood loss, and the time of surgery. There were no statistically significant differences in overall survival and progression-free survival in both groups. We conclude that the percentage of complications related to debulking surgery with intestinal resection in advanced ovarian cancer patients might be accepted. The quantity of complications related to surgery with anastomosis and to Hartmann's procedure is similar. If possible, the surgery with anastomosis should be performed.

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740 ESGO certification for advanced ovarian cancer surgery: the experience of an oncology center to aim accreditation

10.1136/ijgc-2021-esgo.460 ◽

2021 ◽

Author(s):

V Bernardini ◽

S Giulia ◽

DV Antonella ◽

G Stefano ◽

C Giuseppa ◽

...

Keyword(s):

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Cancer Surgery ◽

Oncology Center

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Venous thromboembolism in advanced ovarian cancer patients undergoing front-line adjuvant chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5570 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5570-5570

Author(s):

Alok Pant ◽

Julian C. Schink

Keyword(s):

Ovarian Cancer ◽

Venous Thromboembolism ◽

Adjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Bowel Resection ◽

Prognostic Significance ◽

Advanced Ovarian Cancer ◽

Ca 125 ◽

Front Line ◽

Advanced Epithelial Ovarian Cancer

5570 Background: To define the incidence and prognostic significance of venous thromboembolism (VTE) in patients with advanced, epithelial ovarian cancer undergoing front-line adjuvant chemotherapy after extended period (28 day) post-operative prophylaxis. Methods: A retrospective analysis of patients with advanced, epithelial ovarian cancer who underwent surgery and chemotherapy at a single institution from January 2008 through December 2011 was performed. Exclusion criteria were prior history of VTE, VTE during the post-operative period, clear cell histology, use of anti-coagulation for a different indication, and lack of compliance with 28 days of post-operative prophylaxis with a low molecular weight heparin. Results: 128 patients met criteria for inclusion. Sixteen patients had a reported VTE during the time they were on front line chemotherapy (12.5%). Nine patients (7%) had a pulmonary embolus (PE) and 8 (6.3%) had a deep vein thrombus (DVT). The average BMI in the group that developed VTE was 28 and in the group without VTE was 26.5 (p = 0.23). Three out of 16 (23%) patients who developed VTE had undergone a suboptimal cytoreduction compared to 12/112 (11%) in the group with no VTE (p = 0.4). Six of the 16 (37%) patients who developed VTE during chemotherapy underwent a bowel resection and/or splenectomy during their cytoreductive surgery compared to 18 of 112 (16%) patients who did not develop VTE (p=0.079). Eight of the patients in the VTE group had indwelling venous catheters during chemotherapy (50%) compared to 39 (35%) in the group with no VTE (p = 0.27). In the group that developed VTE, there was a trend towards increased pre-operative CA-125, higher rates of bowel resection and/or splenectomy during surgery, decreased use of aspirin, and inferior survival. On multivariate analysis, patients who developed VTE had significantly longer post-operative hospital stays (7 vs 5 days [p = 0.009]) and lower rates of complete response (p = 0.01). Conclusions: A 12.5% risk of VTE merits consideration of prophylaxis during chemotherapy in this cohort. A randomized, controlled trial is needed to clarify whether the benefits of long term prophylaxis outweigh the risks and costs of such therapy.

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ASO Author Reflections: Rectosigmoid Mesorectal Sparing Resection: A Feasible Technique and a Viable Option in Advanced Ovarian Cancer Surgery

Annals of Surgical Oncology ◽

10.1245/s10434-021-09665-w ◽

2021 ◽

Author(s):

A. Rosati ◽

V. Vargiu ◽

F. Santullo ◽

C. Lodoli ◽

M. Attalla El Halabieh ◽

...

Keyword(s):

Ovarian Cancer ◽

Advanced Ovarian Cancer ◽

Cancer Surgery ◽

Viable Option

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Results of optimal debulking surgery with bowel resection in patients with advanced ovarian cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-016-0800-1 ◽

2016 ◽

Vol 14 (1) ◽

Cited By ~ 4

Author(s):

Pawel Derlatka ◽

Jacek Sienko ◽

Laretta Grabowska-Derlatka ◽

Piotr Palczewski ◽

Anna Danska-Bidzinska ◽

...

Keyword(s):

Ovarian Cancer ◽

Bowel Resection ◽

Advanced Ovarian Cancer ◽

Debulking Surgery ◽

Optimal Debulking

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Risk Factors for GI Adverse Events in a Phase III Randomized Trial of Bevacizumab in First-Line Therapy of Advanced Ovarian Cancer: A Gynecologic Oncology Group Study

Journal of Clinical Oncology ◽

10.1200/jco.2013.53.6524 ◽

2014 ◽

Vol 32 (12) ◽

pp. 1210-1217 ◽

Cited By ~ 48

Author(s):

Robert A. Burger ◽

Mark F. Brady ◽

Michael A. Bookman ◽

Bradley J. Monk ◽

Joan L. Walker ◽

...

Keyword(s):

Risk Factors ◽

Ovarian Cancer ◽

Adverse Events ◽

Bowel Resection ◽

Advanced Ovarian Cancer ◽

Phase Iii ◽

Gynecologic Oncology Group ◽

First Line ◽

Primary Surgery ◽

Taxane Chemotherapy

Purpose To evaluate risk factors for GI adverse events (AEs) within a phase III trial of bevacizumab in first-line ovarian cancer therapy. Patients and Methods Women with previously untreated advanced disease after surgery were randomly allocated to six cycles of platinum-taxane chemotherapy plus placebo cycles (C)2 to C22 (R1); chemotherapy plus bevacizumab C2 to C6 plus placebo C7 to C22 (R2); or chemotherapy plus bevacizumab C2 to C22 (R3). Patients were evaluated for history or on-study development of potential risk factors for GI AEs defined as grade ≥ 2 perforation, fistula, necrosis, or hemorrhage. Results Of 1,873 patients enrolled, 1,759 (94%) were evaluable, and 2.8% (50 of 1,759) experienced a GI AE: 10 of 587 (1.7%, R1), 20 of 587 (3.4%, R2), and 20 of 585 (3.4%, R3). Univariable analyses indicated that previous treatment of inflammatory bowel disease (IBD; P = .005) and small bowel resection (SBR; P = .032) or large bowel resection (LBR; P = .012) at primary surgery were significantly associated with a GI AE. The multivariable estimated relative odds of a GI AE were 13.4 (95% CI, 3.44 to 52.3; P < .001) for IBD; 2.05 (95% CI, 1.09 to 3.88; P = .026) for LBR; 1.95 (95% CI, 0.894 to 4.25; P = .093) for SBR; and 2.15 for bevacizumab exposure (aggregated 95% CI, 1.05 to 4.40; P = .036). Conclusion History of treatment for IBD, and bowel resection at primary surgery, increase the odds of GI AEs in patients receiving first-line platinum-taxane chemotherapy for advanced ovarian cancer. After accounting for these risk factors, concurrent bevacizumab doubles the odds of a GI AE, but is not appreciably increased by continuation beyond chemotherapy.

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