Extended cytoreduction of intraabdominal metastatic ovarian cancer in the left upper quadrant utilizing en bloc resection.

Abstract

The objective of the study was to describe the development of and experience with a technique for en bloc resection of left upper quadrant intraperitoneal metastatic ovarian cancer. From May 7, 2002-August 14, 2004, 6 women underwent en bloc resection of extensive tumor contiguously involving the omentum, colon, gastrocolic ligament and spleen. This represents about 5% of all cytoreductive operations performed during that time. Four of the 6 had received neoadjuvant chemotherapy. A description of the technique is included in the text. Two women required partial gastrectomy and partial pancreatectomy. Separate segmental resection or subtotal colectomy was performed in 3 women. Cytoreduction was optimal in all 6 cases. Significant complications occurred in 3 of the women. Disease-free survival ranged from 2-12 months. In highly selected patients undergoing cytoreductive surgery for ovarian cancer, en bloc resection of extensive left upper quadrant intraabdominal tumor may be a reasonable method for accomplishing optimal cytoreduction.