Intestinal metastasis of ovarian cancer:clinical analysis of 64 cases / 中国现代普通外科进展

ABSTRACT

Objective:To retrospectively analyze the clinical features of intestinal tract metastatic tumors of ovarian cancer,and estimate the feasibility of resection and its relation to prognosis.Methods:64 patients with ovarian cancer associated with intestinal tract metastasis were brought into this clinical analysis.The extent of intestinal tract involvement was evaluated preoperatively.Cytoreduction was defined as the residual lesion less than 1 cm3,at the same time pelvic and paraaortic lymphadenectomy and/or biopsy were implied.Intestinal surgery included tumor stripping surgery and/or intestinal repair,intestinal resection or colostomy.Regular chemotherapy was administrated,postoperative complications as well as prognosis were evaluated.Results:54 cases (84.8%) had rectum/sigmoid colon metastasis,metatsis in other parts of colon were 26 cases,small intestinal metastasis were 18 cases,infiltration of serosal and superficial muscular layer were 47 cases,17 cases had deep muscular layer and mucosal infiltration.Epithelial cancer which had invaded intestinal mucosa were 4 cases (7.7%) ,no invading to intestinal mucosa was detected in germnoma.All the 64 patients were recepted surgical treatment,including tumor stripping surgery in 44 cases,intestinal resection in 20 cases,sigmoidal and rectal resection in 14 cases,and colonost omy in 6 cases.The optical cytoreduction was[FK(WB00018。142mmZQ1mm]achieved in 56 cases (87.5%),and post-chemotherpy regression rate was 58.9%,but the post-chemotherpy regression rate was only 12.5% in 8 patients who got partial resection;regular chemotherapy was finished in 49 cases,and the regression rate was 65.3%,but the regression rate was only 15.4% in those who couldn’t finish regular chemotherapy.Postoperative morbidity was 26.6%,and two patients died of postoperative peritonitis.Conclusion:Intestinal tract is the common metastatic site of ovarian cancer,tumor stripping and intestinal resection are not only feasible but also prerequisite for optimal cytoreduction,postoperative regular chemotherapy can improve prognosis of ovarian cancer.