Relation between type of hysterectomy and survival rate in patients with ovarian cancer – single-center study

Introduction
To evaluate the survival rate of patients with advanced ovarian carcinoma in relation to the type of surgical intervention – total abdominal hysterectomy with bilateral adnexectomy and omentectomy as a minimal standard compared to extended hysterectomy with a retroperitoneal approach.

Material and methods
The study was implemented based on retrospectively obtained data from 104 patients operated on for advanced epithelial ovarian carcinoma (FIGO stages II-IV) in the period from 2004 to 2012. Total abdominal hysterectomy, bilateral adnexectomy, and omentectomy were performed on 23 patients. Extended hysterectomy with a retroperitoneal approach and varying degrees of peritonectomy, omentectomy, and appendectomy were performed on 74 patients. Seven patients were treated with adnexectomy or biopsy alone. We divided the patients into two groups according to the mode of surgery. The first one comprised the patients who underwent radical hysterectomy and the second one comprised total abdominal hysterectomy plus bilateral adnexectomy. The two groups were examined for their overall survival rate, relapse-free survival rate, and 5-year survival rate.

Results
Mean overall survival rate, relapse-free survival rate, and 5-year survival rate in the group with extended hysterectomy were higher compared to the group with total abdominal hysterectomy.

Conclusions
The extended hysterectomy with a retroperitoneal approach with or without systematic lymph node dissection seems to be more appropriate in the surgical treatment of advanced ovarian carcinoma. The procedure is related to the improvement of survival rate as a result of the inclusion of macroscopically invisible lesions in the surgical removal.