Surgery at primary versus relapsed epithelial ovarian cancer: a study on aspects of anaesthesiological management

Abstract

Background: Primary cytoreductive surgery (CS) for epithelial ovarian cancer (EOC) is well-established. CS at relapse remains controversial, with an unclear morbidity profile.

Patients and methods: We analyzed 121 patients with EOC who underwent CS. Two groups were identified by timing of surgery due to primary disease and due to recurrent disease.

Results: CS for primary versus recurrent EOC led to no differences in haemodynamic management, such as transfusion rates, application of vasopressors, ICU and hospital length of stay, or mortality. The risk for postoperative ileus was higher in patients with relapsed versus primary EOC. This might be attributed to patients being operated due to preoperative ileus and a higher small bowel resection rate at CS for relapse.

Conclusion: CS for EOC relapse does not seem to be more challenging in terms of perioperative management compared to that at initial diagnosis. The major surgical morbidity profile was comparable apart from a higher risk for postoperative ileus at relapse.

Keywords: Ovarian cancer; cytoreductive surgery; haemodynamic management; postoperative morbidity; relapse; transfusion.