Extended surgery for ovarian cancer debulking: A single centre audit of practice and outcomes.

Introduction: Residual disease following debulking surgery for advanced epithelial ovarian cancer (EOC) is an important prognostic factor. We aimed to audit the surgical outcomes following standard and extended surgical debulking procedures carried out for management of ovarian cancer. Our secondary aim was to assess the feasibility of introducing extended procedures in a single Australian gynaecological oncology centre. Method(s): A prospective audit of outcomes for patients undergoing surgical debulking for epithelial ovarian cancer was carried out over a 24-month period at The Royal Women's Hospital, Melbourne. The outcome data for standard and extended surgical procedures was analysed for women diagnosed with stage II through to stage IV ovarian cancer. Result(s): Ovarian cancer was diagnosed at stages II-IV in 54 women. 28 (51.9%) of these patients underwent standard surgery and 26 (48.1%) had extended surgery. More patients had complete/optimal debulking in the extended surgery group (84.6%) compared to the standard surgery group (71.4%) for advanced disease (p = 0.495). Grade 3/4 adverse events were recorded in one case in the standard surgery group and eight cases in the extended surgery group. There was no difference in median interval between surgery and commencement of chemotherapy between the two groups (p = 0.79). There were no cases of post-operative mortality. Discussion(s): Implementation of extended surgical procedures for advanced EOC at a tertiary referral centre is feasible with a high rate of complete and optimal debulking and an acceptable level of morbidity.