Rectosigmoidectomy Following Neoadjuvant Chemotherapy for Advanced Ovarian Cancer

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  • 進行卵巣癌に対するneoadjuvant chemotherapy後の直腸合併切除について

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Eleven women underwent rectosigmoidectomy as part of an en bloc removal of the adnexal masses, uterus, and pelvic peritoneum during cytoreductive surgery following neoadjuvant chemotherapy for advanced ovarian cancer. While 7 patients with stage IIIc underwent an exploratory laparotomy, 4 cases with stage IV did not because of their poor performance status (PS). Histologic subtypes were as follows: serous, 10 cases; endometrioid, 1 case. Patients with pleural effusion and ascites received immunotherapy. Thereafter, all patients were treated with 4-6 courses of neoadjuvant chemotherapy with cisplatin containing combinations, which delivered 9 PR, 1 MR and INC. The PS score was improved by neoadjuvant chemotherapy and immunotherapy which may contribute to the low mortality and morbidity. Residual tumor of the largest diameter after debulking surgery were as follows: absent (5 cases), present (< 0.5cm; 2 cases, < 2cm; 3 cases, ≥2cm; 1 case). The median survival for the entire group was 32.6 months. None of 7 cases with residual disease <0.5cm died of the disease within 2 years. Rectosigmoidectomy following neoadjuvant chemotherapy might be a useful procedure for patients who will be left with minimal residual disease after completion debulking surgery.

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