Total parietal peritonectomy in primary debulking surgery for advanced ovarian cancer
With any new treatment course a period of evaluation is appropriate after the initial enthusiasm. It is well known that women who have complete resection of ovarian cancer and any distant metastasis have better outcomes. Often distant metastatic deposits are microscopic, it has been reported that frequently microscopic deposits of ovarian cancer have been demonstrated in seemingly normal peritoneum (the lining of the abdominal wall).
To address this a surgical procedure (total parietal peritonectomy) has been promoted. This review is of 16 patients who underwent this major surgery and looks at the risk-benefit ratio.
The subjects all had advanced ovarian cancer (stage III/IV). There was a high incidence of early post-operative complications in 11 of the 16 patients, one woman died in the early post-operative period. Progression free survival during the 3 years of the study was 63% with two women dying of the disease.
Limitations due to the small size of the sample and possible selection bias are noted. However the authors suggest this radical surgery is beneficial in the right clinical context.
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