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Splenectomy During Secondary Cytoreduction for Ovarian Cancer Disease Recurrence: Surgical and Survival Data

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Abstract

Background

Ovarian cancer disease recurs predominantly in the abdomen, with the spleen usually involved as part of a vast spread of upper-abdominal disease or, less frequently, as an isolated site of disease recurrence. Very few reports are available in the literature on the outcome of patients subjected to splenectomy during secondary cytoreduction. The aim of this study was to identify prognostic factors and to review surgical and clinical data in order to identify those patients who would benefit the most from splenectomy during secondary cytoreduction.

Methods

This was a retrospective review of platinum-sensitive recurrent epithelial ovarian cancer patients who underwent splenectomy as part of secondary cytoreduction. Surgical and survival data were recorded.

Results

Twenty-four patients were identified. Multiple site disease recurrence was observed in 15 patients. The spleen was involved at the hilus in 12 patients; surface and intraparenchymal metastases were equally present. Optimal cytoreduction was achieved in all patients. At a median follow-up of 30 months, median progression-free and overall survival from the time of secondary surgery were 34 and 56 months, respectively. Overall survival was significantly correlated to residual disease at secondary surgery, disease-free survival, consolidation chemotherapy, and type of adjuvant therapy.

Conclusions

Splenectomy as part of secondary cytoreduction is a feasible and safe procedure. Secondary cytoreduction in selected groups of patients is confirmed to be associated with high long-term survival rates even when aggressive surgery of the upper abdomen is required.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, University of Rome “La Sapienza”, V.le Regina Elena, 324, 001161, Rome, Italy

    Natalina Manci MD, Filippo Bellati MD, Marco Calcagno MD, Sagit Arbel Alon MD, Milena Pernice MD & Pierluigi Bendetti Panici MD

  2. Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, Rome, Italy

    Ludovico Muzii MD & Roberto Angioli MD

Authors
  1. Natalina Manci MD
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  2. Filippo Bellati MD
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  3. Ludovico Muzii MD
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  4. Marco Calcagno MD
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  5. Sagit Arbel Alon MD
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  6. Milena Pernice MD
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  7. Roberto Angioli MD
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  8. Pierluigi Bendetti Panici MD
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Correspondence to Natalina Manci MD.

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Manci, N., Bellati, F., Muzii, L. et al. Splenectomy During Secondary Cytoreduction for Ovarian Cancer Disease Recurrence: Surgical and Survival Data. Ann Surg Oncol 13, 1717–1723 (2006). https://doi.org/10.1245/s10434-006-9048-2

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  • DOI: https://doi.org/10.1245/s10434-006-9048-2

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