Colorectal resection in patients with ovarian and primary peritoneal carcinoma

Tebes, Stephen J.; Cardosi, Richard J.; Hoffman, Mitchel S.

doi:10.1016/j.ajog.2006.03.079

Cited by 42 publications

(20 citation statements)

References 19 publications

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“…However, a minority of ovarian cancer metastases invade the entire colon wall. 6 As a result, prediction of the colon resection requirement with colonoscopy was regarded to have low sensitivity, but it may be used for avoiding a misdiagnosis of colon cancer. 13 Although no mucosal invasion was detected with preoperative colonoscopy in the current study, muscularis layer invasion could not be excluded with preoperative colonoscopy or imaging.…”

Section: Discussionmentioning

confidence: 99%

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

Erkılınç¹,

Karataşlı²,

Demir³

et al. 2018

Int J Gynecol Cancer

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ObjectiveThis study aimed to evaluate the outcomes of rectosigmoid resection (RR) and Douglas peritonectomy (DP) on postoperative complications and survival in advanced-stage ovarian cancer surgery.Methods/MaterialsPatients who underwent optimal cytoreductive surgery including RR and DP between January 2007 and January 2013 were included. Patients with deeper invasion into the muscularis and mucosal layer reported in pathology results and colon wall injury necessitating suturing or resection suggesting invasion of implants into the colon wall were excluded. The decision for RR or DP was made according to the surgical team and patients’ preference. Resections were performed with the suspicion of colon wall invasion. The collected data were age, previous operations, preoperative cancer antigen 125 and albumin levels, surgical procedures, duration of surgery, tumor histology, recurrence, hyperthermic intraperitoneal chemotherapy, and length of hospital stay. Kaplan-Meir survival estimates were calculated and compared between the groups using the log-rank test. Cox proportional models were built to evaluate factors that affected disease-free and overall survival.ResultsAge, body mass index, preoperative cancer antigen 125 levels, albumin levels, and amount of ascites were similar between the groups. Neoadjuvant chemotherapy followed by interval debulking surgery was performed in 15% of both groups. End colostomy was performed in 23.7% of the RR group, and only 5.08% of the patients underwent diverting ileostomy procedures. There was no significant difference in terms of surgical complications between the groups. Recurrence occurred in the RR and DP groups at rates of 42% and 47%, respectively. Only primary debulking surgery had an effect on overall survival (odds ratio, 0.5; 95% confidence interval, 0.31–0.88). Overall survival and disease-free survival were similar in the RR and DP groups.ConclusionsDouglas peritonectomy showed similar survival and surgical outcomes to RR and provided shorter hospital stay and earlier admission to chemotherapy in the management of serosal implants during advanced-stage ovarian cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

Erkılınç¹,

Karataşlı²,

Demir³

et al. 2018

Int J Gynecol Cancer

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“…28 All patients received intraoperative IV antiemetics, including a serotonin antagonist, a neurokinin 1 antagonist, and a corticosteroid 30 min before initiation of HIPEC. After surgical cytoreduction, percutaneous inflow and outflow catheters and IP temperature probes were placed as indicated, the skin was closed temporarily, the catheters were connected to the perfusion system (ThermoChem TM HT-1000 System, Indiana, PA), and 3000 mL of normal saline was heated to [41][42][43] C and circulated through the abdomen. Subsequently, cisplatin was added to the perfusate.…”

Section: Methodsmentioning

confidence: 99%

“…However, within this group of surgically and systemically pretreated patients undergoing complex recurrent cancer surgery, the frequency and severity of observed postoperative AEs did not exceed the risk of morbidity of cytoreductive surgery without HIPEC in patients with previously untreated ovarian cancer. [38][39][40][41] Additional randomized clinical trials can address this question.…”

Section: Cancer Therapymentioning

confidence: 99%

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HIPEC ROC I: A phase i study of cisplatin administered as hyperthermic intraoperative intraperitoneal chemoperfusion followed by postoperative intravenous platinum‐based chemotherapy in patients with platinum‐sensitive recurrent epithelial ovarian cancer

Zivanovic

Abramian

Kullmann

et al. 2014

Intl Journal of Cancer

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This phase I study tested the safety, feasibility, pharmacokinetics and pharmacodynamics of cisplatin administered as hyperthermic intraoperative intraperitoneal chemoperfusion (HIPEC) in patients with platinum-sensitive recurrent epithelial ovarian cancer (EOC) undergoing secondary cytoreductive surgery followed by postoperative platinum-based intravenous chemotherapy. Twelve patients with operable, recurrent platinum-sensitive EOC (recurrence !6 months after first-line therapy) were included according to the classical 313 dose-escalation design at three dose levels-60, 80 and 100 mg=m 2 . After surgical cytoreduction, a single dose of cisplatin was administered via HIPEC for 90 min at 41-43 C. Postoperatively, all patients were treated with standard intravenous platinum-based combination chemotherapy. One of six patients experienced a dose-limiting toxicity (grade 3 renal toxicity) at a dose of 100 mg=m 2 . The remaining five patients treated with 100 mg=m 2 tolerated their treatment well. The recommended phase II dose was established at 100 mg=m 2 . The mean peritoneal-to-plasma AUC ratio was 19Á5 at the highest dose level. Cisplatin-induced DNA adducts were confirmed in tumor samples. Common postoperative grade 1-3 toxicities included fatigue, postoperative pain, nausea, and surgical site infection. The ability to administer standard intravenous platinum-based chemotherapy after HIPEC was uncompromised. Cisplatin administered as HIPEC at a dose of 100 mg=m 2 has an acceptable safety profile in selected patients undergoing secondary cytoreductive surgery for platinumsensitive recurrent EOC. Favorable pharmacokinetic and pharmacodynamic properties of HIPEC with cisplatin were confirmed at all dose levels, especially at 100 mg=m 2 . The results are encouraging to determine the efficacy of HIPEC as a complementary treatment in patients with EOC.

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“…Low morbidity and low anastomotic leak rate without the necessity of a protective ileostomy were shown both in primary [21,22] and secondary cytoreductive surgery [23]. Although there seems to be a consensus for intestinal surgery and upper abdominal procedures to achieve optimal debulking, many clinicians still refrain from total or subtotal colectomy, dreading severe postoperative complications and a decreased quality of life.…”

Section: Introductionmentioning

confidence: 99%

Total or Subtotal Colectomy in Patients Undergoing Surgery for Primary or Recurrent Epithelial Ovarian Cancer

Oseledchyk

Abramian²,

Kaiser³

et al. 2014

Oncol Res Treat

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Background: There is controversy as to whether performing a total or subtotal colectomy is justified in patients with advanced ovarian cancer, given its potential for morbidity and a negative effect on long-term quality of life. The aim of this study was to assess the perioperative complications, mortality and outcomes of patients who underwent total or subtotal colectomy as part of the surgical procedure for primary or recurrent epithelial ovarian cancer. Patients and Methods: All patients who had undergone surgery including a total or subtotal colectomy for advanced or recurrent ovarian cancer between 2005 and 2013 at our institution were retrospectively identified. Results: In this time period, 339 patients underwent surgery for epithelial ovarian cancer, which in 11 (3%) patients included a total or subtotal colectomy. Severe grade 3-4 postoperative complications occurred in 3 (27%) patients, and 1 (9%) patient died within 60 days of surgery. Conclusion: A total or subtotal colectomy is associated with increased but acceptable morbidity in selected patients undergoing primary cytoreductive surgery. However, in the recurrent/palliative setting, total or subtotal colectomy should be avoided as the prognosis is poor and the morbidity outweighs the clinical benefit.

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Colorectal resection in patients with ovarian and primary peritoneal carcinoma

Cited by 42 publications

References 19 publications

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes

HIPEC ROC I: A phase i study of cisplatin administered as hyperthermic intraoperative intraperitoneal chemoperfusion followed by postoperative intravenous platinum‐based chemotherapy in patients with platinum‐sensitive recurrent epithelial ovarian cancer

Total or Subtotal Colectomy in Patients Undergoing Surgery for Primary or Recurrent Epithelial Ovarian Cancer

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