Splenectomy in Cytoreductive Surgery for Advanced Ovarian Cancer and Subsequent Intraperitoneal Chemotherapy

Abstract

Abstract

Objectives: The objective of this study was to determine the ability of patients with advanced ovarian cancer to tolerate intraperitoneal (IP) chemotherapy after having undergone optimal cytoreductive surgery (OCRS) requiring splenectomy. Study design: Forty-one (41) consecutive patients with stage III ovarian cancer who had undergone either primary or secondary OCRS, with or without a splenectomy, were identified and subsequently underwent anywhere from one to six cycles of IP chemotherapy. Progression-free survival (PFS), 30-day morbidity from the date of surgery, and number of cycles of IP chemotherapy were calculated and compared. Results: Thirteen (13) patients underwent splenectomy and 28 did not have a splenectomy performed during OCRS. Sixty-nine percent (69%) of patients who underwent splenectomy were able to complete six cycles of IP chemotherapy. Seventy-one percent (71%) of patients who did not undergo splenectomy were able to complete six cycles of IP chemotherapy (p = 0.33). The mean number of IP cycles completed by patients after splenectomy was 4.7 and the mean number following surgery without splenectomy was 5.4 (p = 0.21). The median PFS for patients who underwent splenectomy was 9 months versus 16 months for patients who did not (p = 0.14). Conclusions: Patients who undergo splenectomy at the time of OCRS are just as able as those who do not have a splenectomy to complete a full course of IP chemotherapy. The median PFS is comparable in the two groups. (J GYNECOL SURG 26:179)