Radical Surgical Procedures in Advanced Ovarian Cancer and Differences Between Primary and Interval Debulking Surgery

Abstract

Background/aim: We aimed to identify differences in cytoreduction rates and procedures performed in patients with advanced ovarian cancer undergoing primary (PDS) or interval debulking surgery (IDS).

Patients and methods: Data were collected prospectively on 110 consecutive patients from June 2016 to Mar 2020.

Results: Forty-nine patients (44.5%) underwent diaphragmatic peritonectomy (34 in PDS and 15 in IDS, p=0.005), while 38 (34.5%) underwent large bowel resection (29 in PDS and 9 in IDS, p<0.001). Complete cytoreduction was achieved in 39 patients in PDS and 29 in IDS (65% vs. 58%, p=0.22). Longer operations with more blood loss and extended hospital stay were performed in the PDS group. Ten patients (9.1%) experienced severe complications and in eight patients (7.2%) chemotherapy was delayed.

Conclusion: More bowel resections and diaphragmatic stripping were performed in the PDS group. End surgical results were similar between groups, with a trend for more complete cytoreduction in PDS.

Keywords: Debulking for ovarian cancer; complete cytoreduction; interval debulking surgery; morbidity; primary debulking; upper abdominal surgery.