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Does Extensive Upper Abdomen Surgery During Primary Cytoreduction Impact on Long-term Quality of Life?

Angioli, Roberto MD*; Plotti, Francesco MD*; Aloisi, Alessia MD*; Capriglione, Stella MD*; Terranova, Corrado MD*; Ricciardi, Roberto MD*; Montera, Roberto MD*; Zullo, Marzio Angelo MD*; Rasi, Virginia MD; Benedetti-Panici, Pierluigi MD

International Journal of Gynecological Cancer: March 2013 - Volume 23 - Issue 3 - p 442–447
doi: 10.1097/IGC.0b013e3182842fc4
Ovarian Cancer

Objectives The objective of this study was to evaluate the feasibility in terms of safety and quality of life in a sample of Italian patients affected by advanced ovarian cancer and submitted to either extensive upper abdomen or standard surgery, through validated questionnaires.

Methods From January 2006 to November 2011, a prospective, observational study was conducted to compare quality of life in patients affected by advanced ovarian cancer and submitted to primary cytoreduction in the Division of Gynecology of the University Campus Bio-Medico of Rome. After surgery patients were stratified into 2 groups (group A: standard surgery or group B: extensive upper abdomen surgery). All patients were submitted to standard chemotherapy. At completion of treatment, during the first follow-up visit, all eligible patients were asked to fill in Quality of Life Questionnaire-C30 (QLQ-C30) (version 3.0) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-OV28 (QLQ-OV28) questionnaires.

Results Eighty-nine patients were enrolled into our study. Nine were excluded, so finally 80 patients were considered in this study. Group A included 40 patients and underwent standard surgery (pelvic surgery); group B, included 40 patients and underwent extensive upper abdomen surgery. There were no statistical differences in terms of major surgical complication rates (15% vs 10%). We registered same times of beginning of chemotherapy (median, 19 vs 21 days) and no severe related toxicities. Quality-of-life scores of both questionnaires were comparable between groups, with the exception of Global Health Status in QLC-30.

Conclusions Upper abdomen surgery is a feasible and safe therapeutic option. Patients present same times of beginning of chemotherapy without an increase in chemorelated toxicities and experience the same general quality of life.

*Department of Obstetrics and Gynaecology Campus Bio Medico, †Department of Obstetrics and Gynaecology “Tor Vergata,” and ‡Department of Obstetrics and Gynaecology “Sapienza,” University of Rome, Rome, Italy.

Address correspondence and reprint requests to Roberto Angioli, MD, Department of Obstetrics and Gynecology, University of Rome “Campus Bio-Medico,” Via Alvaro del Portillo, 200-00128 Rome, Italy. E-mail:

The authors declare no conflicts of interest.

Received November 7, 2012

Accepted December 20, 2012

Copyright © 2013 by IGCS and ESGO