Distal pancreatectomy with splenectomy for the management of splenic hilum metastasis in cytoreductive surgery of epithelial ovarian cancer

다국어 초록 (Multilingual Abstract)

Objective: Distal pancreatectomy with splenectomy may be required for optimalcytoreductive surgery in patients with epithelial ovarian cancer (EOC) metastasized tosplenic hilum. This study evaluates the morbidity and treatment outcomes of the uncommonprocedure in the management of advanced or recurrent EOC.
Methods: This study recruited 18 patients who underwent distal pancreatectomy withsplenectomy during cytoreductive surgery of EOC. Their clinicopathological characteristicsand follow-up data were retrospectively analyzed.
Results: All tumors were confirmed as high-grade serous carcinomas. The mediandiameter of metastatic tumors located in splenic hilum was 3.5 cm (range, 1 to 10 cm).
Optimal cytoreduction was achieved in all patients. Eight patients (44.4%) sufferedfrom postoperative complications. The morbidity associated with distal pancreatectomyand splenectomy included pancreatic leakage (22.2%), encapsulated effusion in theleft upper quadrant (11.1%), intra-abdominal infection (11.1%), pleural effusion withor without pulmonary atelectasis (11.1%), intestinal obstruction (5.6%), pneumonia(5.6%), postoperative hemorrhage (5.6%), and pancreatic pseudocyst (5.6%). Therewas no perioperative mortality. The majority of complications were treated successfullywith conservative management. During the median follow-up duration of 25 months,nine patients experienced recurrence, and three patients died of the disease. The 2-yearprogression-free survival and overall survival were 40.2% and 84.8%, respectively.
Conclusion: The inclusion of distal pancreatectomy with splenectomy as part ofcytoreduction for the management of ovarian cancer was associated with high morbidity;however, the majority of complications could be managed with conservative therapy.

참고문헌 (Reference)

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