Department of Gynecology, National Cancer Center-Hospital East, Kashiwa, Chiba, Japan.
Department of Obstetrics and Gynecology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
Int J Gynecol Cancer. 2023 Nov 6;33(11):1771-1777. doi: 10.1136/ijgc-2023-004742.
Total parietal peritonectomy is gradually being recognized as a surgical option for advanced ovarian cancer; however, evidence regarding its efficacy and safety remains insufficient. Herein, we aimed to assess the short- and long-term post-operative safety profiles of total parietal peritonectomy.
We reviewed the medical records of post-operative morbidity and mortality of patients who underwent cytoreductive surgery with total parietal peritonectomy for stage III and IV ovarian cancer between April 2018 and January 2023.
Fifty patients were enrolled in the study: 31 who underwent primary cytoreductive surgery and 19 who underwent interval cytoreductive surgery. The median age of all patients was 57 (range, 23-74) years. The median follow-up period was 22 (range, 3-59) months. Of 44 patients (88%) with stage IIIC/IV, 38 patients (76%) had high-grade serous carcinoma. The complete resection rates were 94%, 91%, and 100% in all patients, the primary cytoreductive surgery group, and the interval cytoreductive surgery group, respectively. There were 63 post-operative complication events overall, including 17 (27%) major complication events in 15 patients within 1 year post-operatively. Ten major complications occurred within 30 days of surgery, mainly in the primary cytoreductive surgery group (9 cases). Regarding complication type, the most frequent major event was pleural effusion (3 cases, 7%). After 30 days, there were a total of 17 all-grade complication events, of which ileus and hydronephrosis were major complications in 3 cases each (18%). There were no mortalities related to cytoreductive surgery. The scheduled adjuvant chemotherapy could be completed in 96% of patients.
Total parietal peritonectomy is a feasible procedure for managing advanced ovarian cancer. Short- and long-term complications may include pleural effusion and ileus/hydronephrosis, respectively.
全腹膜切除术逐渐被认为是治疗晚期卵巢癌的一种手术选择，但关于其疗效和安全性的证据仍然不足。在此，我们旨在评估全腹膜切除术的短期和长期术后安全性。
我们回顾了 2018 年 4 月至 2023 年 1 月期间接受全腹膜切除术治疗 III 期和 IV 期卵巢癌的患者的术后发病率和死亡率的病历记录。
共有 50 名患者入组研究：31 名患者接受了初次细胞减灭术，19 名患者接受了间隔细胞减灭术。所有患者的中位年龄为 57 岁（范围 23-74 岁）。中位随访时间为 22 个月（范围 3-59 个月）。在 44 名（88%）IIIC/IV 期患者中，38 名（76%）为高级别浆液性癌。所有患者、初次细胞减灭术组和间隔细胞减灭术组的完全切除率分别为 94%、91%和 100%。共有 63 例术后并发症事件，包括 15 名患者在术后 1 年内发生的 17 例（27%）严重并发症事件。10 例严重并发症发生在术后 30 天内，主要发生在初次细胞减灭术组（9 例）。关于并发症类型，最常见的严重事件是胸腔积液（3 例，7%）。30 天后，共有 17 例全级别的并发症事件，其中肠梗阻和肾盂积水各有 3 例（18%）为严重并发症。没有与细胞减灭术相关的死亡病例。96%的患者能够完成计划的辅助化疗。
全腹膜切除术是治疗晚期卵巢癌的可行方法。短期和长期并发症可能分别包括胸腔积液和肠梗阻/肾盂积水。
