Background/Objectives: Bowel resection may be necessary during cytoreductive surgery (CS) in advanced epithelial ovarian cancer to achieve complete tumor removal. However, concerns about increased perioperative risks and unclear survival benefits have led to ongoing debate. This study aimed to evaluate the impact of bowel resection on perioperative mortality and overall survival (OS) in patients undergoing CS.Methods: We retrospectively reviewed 127 patients with FIGO stage IIB–IV epithelial ovarian cancer who underwent primary or interval CS between 2007 and 2021. Patients were stratified based on the performance of bowel resection. Clinical, surgical, and survival data were analyzed using Kaplan–Meier survival analysis and Cox proportional hazards modeling. Primary outcomes were 90-day mortality and OS.Results: Bowel resection was performed in 58 patients (46%) with more extensive disease and poorer ECOG performance scores. Although the resection group had increased perioperative risks (e.g., higher transfusion rates and ICU use), OS was similar between groups (log-rankp= 0.122). Multivariate analysis identified that increasing age (HR = 1.042,p= 0.005) was independently associated with poorer OS, whereas lymph node dissection (HR = 0.450,p= 0.003) and undergoing primary CS (HR = 0.540,p= 0.047) were associated with improved survival. Bowel resection was not independently associated with OS.Conclusions: Bowel resection does not adversely affect OS when optimal cytoreduction is achieved. Although it increases perioperative complexity, it can be safely incorporated into CS in selected patients. These findings support its use as part of an individualized surgical strategy for advanced ovarian cancer.
背景/目的：在晚期上皮性卵巢癌的肿瘤细胞减灭术中，为达到完全切除肿瘤的目的，可能需要进行肠管切除。然而，由于担心围手术期风险增加及生存获益不明确，这一做法一直存在争议。本研究旨在评估肠管切除对接受肿瘤细胞减灭术患者围手术期死亡率及总生存期的影响。 方法：我们回顾性分析了2007年至2021年间接受初次或间歇性肿瘤细胞减灭术的127例FIGO分期为IIB–IV期的上皮性卵巢癌患者。根据是否进行肠管切除对患者进行分层，并采用Kaplan–Meier生存分析和Cox比例风险模型分析临床、手术及生存数据。主要结局指标为90天死亡率和总生存期。 结果：58例患者（46%）接受了肠管切除，这些患者疾病范围更广且ECOG体能状态评分更差。尽管切除组围手术期风险更高（如输血率和ICU使用率增加），但两组总生存期相似（时序检验p=0.122）。多变量分析显示，年龄增长（HR=1.042，p=0.005）与总生存期较差独立相关，而淋巴结清扫（HR=0.450，p=0.003）和接受初次肿瘤细胞减灭术（HR=0.540，p=0.047）与生存改善相关。肠管切除与总生存期无独立关联。 结论：在实现满意肿瘤细胞减灭的前提下，肠管切除不会对总生存期产生负面影响。尽管其增加了围手术期的复杂性，但在经过选择的患者中可安全实施。这些发现支持将肠管切除作为晚期卵巢癌个体化手术策略的一部分。
肿瘤(癌症)患者之家