INTRODUCTION
In early ovarian cancer, unique characteristics such as a higher incidence of non-serous histology and co-existence of endometriosis are identified.1 Endometriosis is genetically linked to ovarian cancer and endometriosis is a precursor lesion of clear cell and endometrioid ovarian cancer.2, 3 Endometriosis-related ovarian cancer is diagnosed in an earlier stage compared to high grade serous ovarian cancer.4
Resection of the rectosigmoid colon is frequently performed as parts of the cytoreductive surgical procedure of ovarian cancer5. The surgical investigation has been investigated mainly focusing on the advanced stage ovarian cancer.6, 7 The surgical resection of the rectosigmoid colon has not been investigated in early ovarian cancer till now. Given the higher prevalence of endometriosis in earlier stage ovarian cancer, the surgical management of the rectosigmoid colon might be more complex than those of advanced ovarian cancer. Because the bowel excision is sometimes required for complete excision of ovarian cancer and pelvic endometriosis as well.8 Complete excision of all suspicious lesions for endometriosis or ovarian cancer may be more important in the surgical management of ovarian cancer because intra-operative differentiation of endometriosis from ovarian cancer is difficult and endometriosis has been suggestive of possible precursor lesion of ovarian cancer.9, 10
Based on these backgrounds, we investigated the incidence of surgical resection of the rectosigmoid colon required to remove all suspicious lesions in the surgical management of early ovarian cancer and pathological outcomes.