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Medline ® Abstract for Reference 23

of 'Cancer of the ovary, fallopian tube, and peritoneum: Surgery for recurrent cancer'

Splenectomy in recurrent epithelial ovarian cancer.
Gemignani ML, Chi DS, Gurin CC, Curtin JP, Barakat RR
Gynecol Oncol. 1999 Mar;72(3):407-10.
OBJECTIVE: To report a series of patients with recurrent epithelial ovarian cancer who underwent splenectomy for isolated parenchymal metastases.
METHODS: We performed a retrospective review of all patients who had a splenectomy for ovarian cancer at our institution during the period 1991 to 1997.
RESULTS: Six patients were identified who had a splenectomy performed for recurrent epithelial ovarian cancer confined to the splenic parenchyma. All had initial cytoreductive surgery for Stage III disease followed by platinum-based chemotherapy. Five patients underwent second-look surgery and four of them had pathologically confirmed persistent disease. All five patients who underwent second-look surgery had an intraperitoneal (ip) port placed and received platinum-based ip chemotherapy. Computed tomography (CT) scan performed during the posttreatment surveillance period demonstrated recurrent disease confined to the spleen in all six patients. Splenectomy was performed at a median of 57 months (range 28-88 months) after the initial surgery. The only major complication was a diaphragmatic tear necessitating chest tube placement. With a median follow-up of 25.5 months (range 6-65 months), all six patients are alive and free of disease.
CONCLUSION: Splenectomy is a safe and feasible procedure in recurrent epithelial ovarian cancer. Isolated parenchymal splenic metastasis may occur as a late recurrence in epithelial ovarian cancer and splenectomy should be considered a part of the management of this group of patients.
Gynecology Service Academic Office, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, 10021, USA.