The objective of the research was to estimate early and long-term results of secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs. Materials and methods. The study included 62 patients with recurrent ovarian cancer treated in the Institute of General and Emergency Surgery named after V.T. Zaitsev of the Academy of Medical Sciences of Ukraine during January 2009 -September 2015. Selection criteria for secondary cytoreductive surgery were the following: recurrent ovarian cancer with involvement of the bladder and/or the ureter, no urologic surgery during primary cytoreductive surgery, the ECOG performance status of 0-2. Urological surgery that had been a subject to the analysis was the following: cystoscopy with or without intraoperative urethral stenting, bladder resection, ureterectomy, ureteral reimplantation, cystectomy with further reconstruction. Evaluation criteria included the presence and the level of surgical and postoperative urological complications within 30 days after surgery, relaparatomy rates, postoperative mortality, type of cytoreduction. Long-term results were evaluated through recurrence rates after secondary cytoreductive surgery, median survival, disease-free survival and overall survival. Results. Volumes of performed surgery (excluding urological one) were the following: lymphadenectomy (n=29; 46.7%), bowel resection (n=17; 27.4%), vascular resection (n=4; 6.5%) and others. Minimally invasive urological surgery included urethral stenting (n=6; 9.7%) and cystoscopy (n=13; 20.9%). Bladder resection was performed in 26 (41.9%) cases, cystectomy -in 17 (27.4%) cases. R0 resections were performed in all the cases. Postoperative non-urological complications were observed in 7 (11.2%) patients. Urological complications were found in 9 (14.5%) patients. Postoperative mortality was 3.2%. Recurrence was documented in 7 (11.3%) cases. Median survival was 24 months. Follow-up mortality was 30% (n=18). Conclusions. The results of combined secondary cytoreductive surgery performed for recurrent ovarian cancer with involvement of urinary organs indicate the possibility of en bloc resection of tumor and surrounding organs at acceptable rates of postoperative complications and mortality. Extended combined surgery and even pelvic exenteration are effective in treatment of patients with recurrent ovarian cancer. Keywords Problem statement and analysis of the recent researchTreatment of recurrent ovarian cancer (ROC) with multidisciplinary approach has been developed during the last decade. The collaboration of highly qualified specialists (chemotherapeutists, radiologists, oncogynecologists, oncourologists, vascular surgeons, etc.) allows to extend indications for secondary cytoreductive surgery (SCRS) and to increase the rate of optimal cytoreduction which are the principal factors for improved long-term outcomes.Topographic features of female pelvis contribute to local spread of ovarian cancer on the surrounding anatomical structures including u...

No abstract

Inaccurate lymph node staging affects treatment planning and may contribute to worse prognosis. A retrospective study was performed to confirm this hypothesis. Materials and methods: Data about patients diagnosed with stage I-III endometrial cancer between January 1, 2008 and December 31, 2009 (cases with multiple primary tumors were excluded) was extracted from cancer register of Kyiv City Clinical Oncology Centre. Hypothesis: The absence of lymphadenectomy in a patient with apparent early stage endometrial cancer, but with undiagnosed lymph node metastases may lead to understaging and undertreatment with worse prognosis and outcomes. Cancer-specific survival was the primary outcome. Results: From 564 patients assessed for eligibility, 61 were excluded. Cancer-related death was reported in 76 cases: 39 stage I, 14 -stage II, and 23 -stage III patients. Median cancer-specific survival was 27 months for stage I, 14 months for stage II, and 19 months for stage III (p = 0.01). Three-year cancer-specific survival rate was 33.3% for stage I, 0% for stage II, and 17.4% for stage III. Intergroup analysis showed a statistically significant difference in survival between stage I and stage II patients (p = 0.005), but there was no statistically significant difference in survival between stage III and stage I or II patients (p = 0.072 and p = 0.151, respectively). Conclusions: The same rates of cancer-specific survival may indicate that the presented cases of apparently early stage endometrial cancer were understaged and consequently undertreated. Further studies in larger groups of patients are needed.