Pancreatic Resection as Part of Cytoreductive Surgery in Advanced-stage and Recurrent Epithelial Ovarian Cancer--A Single-center Experience

Abstract

Aim: To demonstrate the efficacy of pancreatic resection as part of cytoreductive surgery for advanced-stage and recurrent epithelial ovarian cancer.

Patients and methods: Data of patients submitted to cytoreductive surgery for advanced-stage and relapsed epithelial ovarian cancer at the Dan Setlacec Center of Gastrointestinal Disease and Liver Transplantation, Fundeni Clinical Institute, Romania, treated between January 2002 and May 2014 were retrospectively reviewed.

Results: A total of six cases were eligible for the study: one case was submitted to pancreatic resection in the context of primary cytoreduction, four cases were submitted to pancreatic resection during secondary cytoreduction, while the sixth case was submitted to distal pancreatectomy as part of tertiary cytoreduction. The early postoperative course was uneventful in four cases, while the other two developed pancreatic fistulas. In one case, the leak was managed in a conservative manner, while in the second case re-operation was required. Thirty-day mortality was zero. At the time of writing, the patient submitted to pancreatic resection during primary cytoreduction was still alive with disease at 54 months and proposed for secondary cytoreduction. The median overall survival for cases submitted to pancreatic resection in the context of secondary cytoreduction was 36.38 months, while the patient submitted to distal pancreatectomy at the moment of tertiary cytoreduction was dead of disease 10 months after surgery.

Conclusion: Pancreatic resections can be safely performed in the context of cytoreductive surgery for advanced-stage and relapsed epithelial ovarian cancer, with acceptable rates of morbidity, therefore benefit in terms of survival might be achieved.

Keywords: Advanced-stage ovarian cancer; cytoreductive surgery; pancreatic resection; recurrence.