Clinical implication of endometriosis in the surgical management of
early ovarian cancer
Abstract
Objective To investigate the surgical effort of endometriosis the in the
surgical management of early ovarian cancer. Design: A retrospective
study Setting National Cancer Center Population All women who underwent
cytoreductive surgery between January 2001 and July 2008 Method:
Retrospective medical chart review Main Outcomes Measure Requirement of
the rectosigmoid colon and pathological outcome of resected the
rectosigmoid colon Results: Of the 37 stage I and 15 stage II ovarian
cancer women, twelve cases (23.1%) were serous carcinomas and 40
(76.9%) were non-serous carcinomas (9 mucinous, 11 endometrioid, 14
clear cell, 2 transitional cell, and 4 mixed carcinomas). Co-existence
of endometriosis was identified in 28.8% of the patients at adnexa,
pelvic peritoneum, and rectum. Resection of the rectosigmoid colon to
completely resect all suspicious lesions was required in 15 patients
(28.8%). Cancer and endometriosis were identified in 6 (40%) and 5
(33%) patients, respectively. Fibrosis and/or adhesion were identified
in 4 (27%) patients. Complications related resection of the
rectosigmoid colon such as fistula or leakage were not identified with a
median follow up of 50 months. Conclusions: Resection of the
rectosigmoid colon with adjacent pelvic peritonectomy is required in
approximately one-third of the patients with early ovarian cancer for
complete removal of all suspicious metastatic lesions in the pelvis.
Cancer invasion, endometriosis, and fibrosis and/or adhesion are the
causes to perform resection of the rectosigmoid colon in such patients.