Abstract
Background . Comparative assessment of the long-term oncological results of extended, combined and standard surgical interventions. Materials and methods . The study included women with histologically verified ovarian cancer T3—4N0—1M0—1. Group A (experimental) patients underwent advanced and combined surgical interventions; group B (control) patients underwent standard surgical interventions. In the postoperative period, all patients received 6 courses of polychemotherapy with a combination of platinum and taxanes. The authors compared the frequency of achieving optimal and conditionally radical operations after performing extended and combined operations and standard surgical interventions, the structure, frequency and causes of intra- and postoperative complications, and overall and disease-free survival. Results . From 2010 to 2018, we selected 150 archived case histories of patients with advanced ovarian cancer (III-IV stages). 135 (90 %) patients were able to track the long-term results of treatment. In group A (experimental), complete debulking was achieved in 52.8 %, in group B (control) — 26.7 %. In group A, 6 (19.9 %) patients had postoperative complications of I-II degree of severity, 1 patient had postoperative complications of IIIA degree of severity, complications of IIIB-IV degree of severity in the study group did not occur (p = 0.05). In group B, intraoperative complications were observed in 27 (22.5 %) patients. Postoperative I—II degrees of severity were observed in 28 (23.3 %) patients, III—IV degrees of severity — in 8 (6.6 %). In group B, the overall survival rate was 54.7 months, and re¬lapse-free was 14.3 months, in group A — 79.2 months and 19 months respectively (p = 0.004 and <0.05). Conclusions . The method of choosing treatment for patients with advanced ovarian cancer in the first stage is surgery in the amount of com - plete debulking. Performing combined and advanced operations for advanced ovarian cancer affects the success of complete debulking and is reasonable.
Highlights
Comparative assessment of the long-term oncological results of extended, combined and standard surgical interventions
In group A, complete debulking was achieved in 52.8 %, in group B – 26.7 %
Performing combined and advanced operations for advanced ovarian cancer affects the success of complete debulking and is reasonable
Summary
Цель исследования – сравнительная оценка отдаленных онкологических результатов расширенных, комбинированных и стандартных хирургических вмешательств. Проследить отдаленные результаты лечения удалось у 135 (90 %) больных. В группе А (исследования) полной циторедукции удалось достичь в 53,3 % случаев, в группе В (контроля) – в 26,7 %. В группе А у 6 (19,9 %) больных имелись послеоперационные осложнения I–II степени тяжести, у 1 больной – IIIA степени, осложнения IIIB–IV степени тяжести в группе исследования не встречались (р = 0,05). Послеоперационные осложнения I–II степени тяжести отмечены у 28 (23,3 %) пациенток, III–IV степени тяжести – у 8 (6,6 %). Выполнение комбинированных и расширенных операций при распространенном раке яичников влияет на успех выполнения полной циторедукции и является обоснованным. Для цитирования: Секерская М.Н., Никогосян С.О., Кузнецов В.В. Отдаленные результаты хирургического лечения распространенного рака яичников на этапе первичной циторедукции. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia; 24 Kashirskoe Shosse, Moscow 115478, Russia
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