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.