Abstract：
Oncovascular surgery (the removal of major blood vessels infiltrated by cancer) is challenging but can be key to achieve complete cytoreduction in patient with advanced ovarian cancer. The aim of this study was to review the literature on oncovascular surgery in ovarian cancer and to report the details of all the cases performed at our institution.
We retrospectively reviewed the database of ovarian cancer patients who underwent debulking surgery at the Department of Obstetrics and Gynecology of Verona University between January 2021 and 2023. Patients with at least one major vessel resection during cytoreduction were identified. We then systematically review the literature searching Pubmed and Embase from inception to January 2023 to report all cases of surgery for ovarian cancer with concomitant major vessel resection.
Five patients with advanced/recurrent ovarian cancer underwent major vascular resection at our institution. Vascular involvement was preoperatively identified in all cases and no case of vascular resection was performed after accidental injury. The major vessels removed were the inferior vena cava (n = 2), the common iliac veins (n = 2), the external iliac arteries (n = 2), the left common iliac artery (n = 1), and the left external iliac vein (n = 1). All patients underwent other non-gynecological cytoreductive procedures prior to vessel removal and had R0 obtained. Three (60%) patients experienced one or more postoperative complications. The literature search identified a total of seven cases of major vessels resection in ovarian cancer surgery. A single or multiple major vessels were removed in two (28.6%) and five (72.4%) cases, respectively. All the seven patients underwent vascular reconstruction. Four (57.1%) patients reported postoperative complications. Overall, 66.7% of the 12 total identified patients were free from disease at the last follow-up [median 15.5 months (range 5-25)].
Oncovascular surgery is feasible in selected patients with ovarian cancer, provided that a multidisciplinary approach with customized care is available.
We retrospectively reviewed the database of ovarian cancer patients who underwent debulking surgery at the Department of Obstetrics and Gynecology of Verona University between January 2021 and 2023. Patients with at least one major vessel resection during cytoreduction were identified. We then systematically review the literature searching Pubmed and Embase from inception to January 2023 to report all cases of surgery for ovarian cancer with concomitant major vessel resection.
Five patients with advanced/recurrent ovarian cancer underwent major vascular resection at our institution. Vascular involvement was preoperatively identified in all cases and no case of vascular resection was performed after accidental injury. The major vessels removed were the inferior vena cava (n = 2), the common iliac veins (n = 2), the external iliac arteries (n = 2), the left common iliac artery (n = 1), and the left external iliac vein (n = 1). All patients underwent other non-gynecological cytoreductive procedures prior to vessel removal and had R0 obtained. Three (60%) patients experienced one or more postoperative complications. The literature search identified a total of seven cases of major vessels resection in ovarian cancer surgery. A single or multiple major vessels were removed in two (28.6%) and five (72.4%) cases, respectively. All the seven patients underwent vascular reconstruction. Four (57.1%) patients reported postoperative complications. Overall, 66.7% of the 12 total identified patients were free from disease at the last follow-up [median 15.5 months (range 5-25)].
Oncovascular surgery is feasible in selected patients with ovarian cancer, provided that a multidisciplinary approach with customized care is available.
摘要：
背景：肿瘤血管手术（切除被癌症浸润的主要血管）具有挑战性，但可能是晚期卵巢癌患者实现完全细胞减少的关键。这项研究的目的是回顾有关卵巢癌肿瘤血管手术的文献，并报告在我们机构进行的所有病例的详细信息。
方法：我们回顾性回顾了2021年1月至2023年在维罗纳大学妇产科接受切除手术的卵巢癌患者的数据库。确定了在细胞减少术中至少进行过一次主要血管切除的患者。然后，我们系统地回顾了从成立到2023年1月的文献搜索Pubmed和Embase，以报告所有伴有主要血管切除的卵巢癌手术病例。
结果：5例晚期/复发性卵巢癌患者在我们机构接受了大血管切除术。在所有病例中，术前都确定了血管受累，并且在意外伤害后没有进行血管切除。切除的主要血管是下腔静脉（n=2），髂总静脉（n=2），髂外动脉（n=2），左髂总动脉(n=1),和左髂外静脉（n=1）。所有患者在去除血管之前都接受了其他非妇科细胞减灭术，并获得了R0。三名（60％）患者经历了一种或多种术后并发症。文献检索确定了总共7例卵巢癌手术中的主要血管切除术。在2例（28.6%）和5例（72.4%）中切除了单个或多个主要血管，分别。7例患者均行血管重建。4例（57.1%）患者报告术后并发症。总的来说,12例确诊患者中66.7%在末次随访时无疾病[中位数15.5个月(范围5-25)]。
结论：在选择的卵巢癌患者中进行肿瘤血管手术是可行的，前提是提供具有定制护理的多学科方法。
方法：我们回顾性回顾了2021年1月至2023年在维罗纳大学妇产科接受切除手术的卵巢癌患者的数据库。确定了在细胞减少术中至少进行过一次主要血管切除的患者。然后，我们系统地回顾了从成立到2023年1月的文献搜索Pubmed和Embase，以报告所有伴有主要血管切除的卵巢癌手术病例。
结果：5例晚期/复发性卵巢癌患者在我们机构接受了大血管切除术。在所有病例中，术前都确定了血管受累，并且在意外伤害后没有进行血管切除。切除的主要血管是下腔静脉（n=2），髂总静脉（n=2），髂外动脉（n=2），左髂总动脉(n=1),和左髂外静脉（n=1）。所有患者在去除血管之前都接受了其他非妇科细胞减灭术，并获得了R0。三名（60％）患者经历了一种或多种术后并发症。文献检索确定了总共7例卵巢癌手术中的主要血管切除术。在2例（28.6%）和5例（72.4%）中切除了单个或多个主要血管，分别。7例患者均行血管重建。4例（57.1%）患者报告术后并发症。总的来说,12例确诊患者中66.7%在末次随访时无疾病[中位数15.5个月(范围5-25)]。
结论：在选择的卵巢癌患者中进行肿瘤血管手术是可行的，前提是提供具有定制护理的多学科方法。
