MATERIALS AND METHODS
After obtaining Institutional Review Board approval, we used the cancer
registry and patient medical records of the National Cancer Center to
identify all patients diagnosed with pathology-proven early ovarian
cancer (FIGO stage I, II) who underwent cytoreductive surgery between
January 2001 and July 2008. We performed a retrospective chart review
and collected all demographic, clinical, surgical, and pathologic
information.
The images and biopsy results of all patients were discussed at the
tumour board conference, which is a multidisciplinary team consisting of
gynecologic oncologists, radiation oncologists, diagnostic radiologists,
pathologists, and nuclear medicine physicians. All operations were
performed by gynecologic oncologists leading a comprehensive surgical
team, including colorectal and urologic surgeons. Standard cytoreductive
procedures, including hysterectomy, salpingo-oophorectomy, omentectomy,
pelvic and para-aortic lymph node dissection, and appendectomy, were
routinely performed for all patients with early ovarian cancer who did
not need to preserve fertility. Pelvic peritonectomy and resection of
the rectosigmoid colon were selectively performed as part of
cytoreductive surgery for complete removal of all visible tumours for
early ovarian cancer.
All cytoreductive surgeries, including resection of low anterior
resection, were performed by gynecologic oncologists. Mobilization of
proximal healthy colon and anastomosis between the sigmoid colon and
rectal stump was performed by a colorectal surgeon with a gynecologic
oncology fellow. Our surgical policy in the surgical management of
endometriosis and ovarian cancer is complete surgical excision of all
suspicious lesions as complete as possible.