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open access

Vol 94, No 10 (2023)
Research paper
Published online: 2023-03-03
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The impact of splenectomy and diaphragmatic surgery on perioperative morbidity and overall survival of ovarian cancer patients

Artur Skowyra1, Sebastian Szubert2, Tomasz Rajs3, Blazej Nowakowski4, Lukasz Wicherek5
DOI: 10.5603/GP.a2023.0028
·
Pubmed: 36929791
·
Ginekol Pol 2023;94(10):807-815.
Affiliations
  1. 2nd Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
  2. Division of Gynaecological Oncology, Department of Gynaecology, Poznan University of Medical Sciences, Poznan, Poland, Poland
  3. Clinical Department of Colorectal, General and Oncological Surgery, Centre of Postgraduate Medical Education, Warsaw, Poland
  4. Surgical, Oncology and Endoscopic Gynecology Department, The Greater Poland Center Cancer, Poznan, Poland
  5. School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland

open access

Vol 94, No 10 (2023)
ORIGINAL PAPERS Gynecology
Published online: 2023-03-03

Abstract

Objectives: The prognosis of ovarian cancer (OC), among other factors, depends on residual disease after primary debulking surgery (PDS) and initial disease advancement. The main aim of our study was to evaluate the survival benefits of splenectomy and diaphragmatic surgery in OC patients, when the procedures result in resection to no macroscopic residual disease or minimal residual disease [tumor nodules below 2.5 mm according to Sugarbaker’s completeness of cytoreduction score (CC) = 1]. Material and methods: The study included 25 OC patients after splenectomy procedures, 28 patients after diaphragmatic surgery and 17 patients who had undergone both splenectomy and diaphragmatic surgery. Patients’ overall survival (OS) was compared with residual disease-matched controls (47 patients) who had upper abdomen involvement but no requirement for splenectomy and/or diaphragmatic surgery. Results: Overall survival of patients after splenectomy was not significantly different from OS of patients who did not required splenectomy (36.1 vs 31.6 months; p = 0.85). No differences in OS were observed between patients who did and did not require diaphragmatic surgery (31.3 vs 41.8; p = 0.33). Similarly, we found no differences in OS between patients who underwent both splenectomy and diaphragmatic surgery and those patients who did not require either procedure (20.1 vs 31.6 months; p = 0.45). Splenectomies and diaphragmatic surgeries were associated with prolonged hospitalization and length of surgery, however, no specific morbidity related to the procedures was observed. Conclusions: In the cases of advanced OC, diaphragm and spleen involvement do not hamper patient prognosis when adequately resected.

Abstract

Objectives: The prognosis of ovarian cancer (OC), among other factors, depends on residual disease after primary debulking surgery (PDS) and initial disease advancement. The main aim of our study was to evaluate the survival benefits of splenectomy and diaphragmatic surgery in OC patients, when the procedures result in resection to no macroscopic residual disease or minimal residual disease [tumor nodules below 2.5 mm according to Sugarbaker’s completeness of cytoreduction score (CC) = 1]. Material and methods: The study included 25 OC patients after splenectomy procedures, 28 patients after diaphragmatic surgery and 17 patients who had undergone both splenectomy and diaphragmatic surgery. Patients’ overall survival (OS) was compared with residual disease-matched controls (47 patients) who had upper abdomen involvement but no requirement for splenectomy and/or diaphragmatic surgery. Results: Overall survival of patients after splenectomy was not significantly different from OS of patients who did not required splenectomy (36.1 vs 31.6 months; p = 0.85). No differences in OS were observed between patients who did and did not require diaphragmatic surgery (31.3 vs 41.8; p = 0.33). Similarly, we found no differences in OS between patients who underwent both splenectomy and diaphragmatic surgery and those patients who did not require either procedure (20.1 vs 31.6 months; p = 0.45). Splenectomies and diaphragmatic surgeries were associated with prolonged hospitalization and length of surgery, however, no specific morbidity related to the procedures was observed. Conclusions: In the cases of advanced OC, diaphragm and spleen involvement do not hamper patient prognosis when adequately resected.

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Keywords

ovarian cancer surgery; splenectomy; diaphragmatic surgery; cytoreductive surgery; debulking surgery

About this article
Title

The impact of splenectomy and diaphragmatic surgery on perioperative morbidity and overall survival of ovarian cancer patients

Journal

Ginekologia Polska

Issue

Vol 94, No 10 (2023)

Article type

Research paper

Pages

807-815

Published online

2023-03-03

Page views

358

Article views/downloads

371

DOI

10.5603/GP.a2023.0028

Pubmed

36929791

Bibliographic record

Ginekol Pol 2023;94(10):807-815.

Keywords

ovarian cancer surgery
splenectomy
diaphragmatic surgery
cytoreductive surgery
debulking surgery

Authors

Artur Skowyra
Sebastian Szubert
Tomasz Rajs
Blazej Nowakowski
Lukasz Wicherek

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