J 2017

Modified posterior pelvic exenteration for advanced ovarian malignancies: a single-institution study of 35 cases

MINÁŘ, Luboš, Michal FELSINGER, Ivo ROVNÝ, Filip ZLÁMAL, Julie BIENERTOVÁ VAŠKŮ et. al.

Basic information

Original name

Modified posterior pelvic exenteration for advanced ovarian malignancies: a single-institution study of 35 cases

Authors

MINÁŘ, Luboš (203 Czech Republic, guarantor, belonging to the institution), Michal FELSINGER (203 Czech Republic), Ivo ROVNÝ (203 Czech Republic), Filip ZLÁMAL (203 Czech Republic, belonging to the institution), Julie BIENERTOVÁ VAŠKŮ (203 Czech Republic, belonging to the institution) and Eva JANDÁKOVÁ (203 Czech Republic)

Edition

Acta Obstetricia et Gynecologica Scandinavica, Hoboken, Brill, 2017, 0001-6349

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.649

RIV identification code

RIV/00216224:14110/17:00097520

Organization unit

Faculty of Medicine

DOI

UT WoS

000407745700015

Keywords in English

Advanced ovarian cancer; modified posterior pelvic exenteration; residual disease; disease-free survival; surgical complications

Tags

Tags

International impact, Reviewed
Změněno: 18/3/2018 17:05, Soňa Böhmová

Abstract

V originále

IntroductionThis study aimed to investigate the possible benefits of a complete cytoreduction in patients with advanced ovarian cancer and concomitant rectal invasion. Furthermore, we evaluated the morbidity associated with radical surgery. Material and methodsA retrospective analysis examined 35 women who underwent radical surgery in the form of modified posterior pelvic exenteration. Descriptive statistics, Kaplan-Meier survival curves and log-rank test were used for statistical estimations. Surgical complications were analyzed using the Clavien-Dindo classification. ResultsThe analysis of survival in relation to residual disease assessed according to Sugarbaker confirmed an optimistic prognosis in patients with optimal debulking with a mean disease-free survival period of 33.6 months in R0 patients, 19.6 months in R1 patients, and 14.3 months in R2 patients. A statistically significant difference in disease-free survival (p = 0.023) was observed between the R0 (without residual disease) and R1+2 (with residual disease) groups. Surgical complications occurred in 83% of patients, with early postoperative complications being most frequent (65.7%). While grade III-IV complications occurred in 37.7% of all patients, no cases of surgery-associated mortality occurred. ConclusionsModified posterior pelvic exenteration is a highly effective method for achieving optimal debulking in cases of advanced ovarian cancer with the direct invasion of the rectum. Modified posterior pelvic exenteration does not delay the beginning of complementary chemotherapy. However, it is necessary to take into account surgery-related morbidity. As modified posterior pelvic exenteration represents an extremely invasive technique, the surgical plan and perioperative care should be personalized to address the individual medical and surgical conditions of each patient.