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Success rate and safety of tumor debulking with diaphragmatic surgery for advanced epithelial ovarian cancer and peritoneal cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

In advanced epithelial ovarian and peritoneal cancer, residual tumor diameter correlates with prognosis; therefore, maximum debulking and optimal surgery (OS) for residual tumors <1 cm is warranted. Here, we clarified the efficacy of tumor debulking with diaphragmatic surgery (DS).

Methods

In 45 patients with epithelial ovarian or peritoneal cancer who underwent DS (ten, full-thickness resection; 35, stripping) between January 2010 and December 2013 at two related institutions, we retrospectively evaluated OS safety and success by surgical duration, blood loss, complications, hospitalization stay, and residual tumor diameter and site.

Results

Blood loss was 4,090.8 and 2,847.9 mL; surgical duration was 485.2 and 479.5 min; hospitalization stay was 21.7 and 24.8 days; and complications included intraoperative thoracotomy in 17 and 7 patients, unexpected thoracotomy in 11 and 3, chest drain insertion in one and three, and pleural effusion in 14 and 7, in the primary debulking surgery (PDS) and interval debulking surgery (IDS) groups, respectively. OS was successful in all patients with complete surgery (CS: no residual tumor) achieved in 16 (50.0 %) and 9 (69.2 %), residual tumor diameter < 5 mm in 11 (34.4 %) and 2 (15.4 %), and residual tumor diameter < 1 cm in 5 (15.6 %) and 2 (15.4 %) in the PDS and IDS groups, respectively.

Conclusions

Tumor debulking surgery with DS resulted in controllable blood loss, and OS was successful in all patients without severe complications or postoperative treatment delay. Currently, OS is considered to have very few benefits over CS; thus, the success rate of CS rate should be improved while maintaining safety.

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Authors and Affiliations

  1. Department of Obstetrics/Gynecology, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-Ku, Tokyo, 105, Japan

    Motoaki Saitou, Yasushi Iida, Hiromi Komazaki, Chikage Narui, Kanae Matsuno, Ayako Kawabata, Kazu Ueda, Hiroshi Tanabe, Satoshi Takakura, Seiji Isonishi, Hiroshi Sasaki & Aikou Okamoto

Authors
  1. Motoaki Saitou
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  2. Yasushi Iida
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  3. Hiromi Komazaki
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  4. Chikage Narui
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  5. Kanae Matsuno
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  6. Ayako Kawabata
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  7. Kazu Ueda
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  8. Hiroshi Tanabe
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  9. Satoshi Takakura
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  10. Seiji Isonishi
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  11. Hiroshi Sasaki
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  12. Aikou Okamoto
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Corresponding author

Correspondence to Motoaki Saitou.

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Saitou, M., Iida, Y., Komazaki, H. et al. Success rate and safety of tumor debulking with diaphragmatic surgery for advanced epithelial ovarian cancer and peritoneal cancer. Arch Gynecol Obstet 291, 641–646 (2015). https://doi.org/10.1007/s00404-014-3446-7

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  • DOI: https://doi.org/10.1007/s00404-014-3446-7

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