Survival impact of bowel resection at the time of interval cytoreductive surgery for advanced ovarian cancer

Highlights • Bowel resection is associated with decreased three-year survival. • Bowel resection does not impact progression free survival. • Bowel resection is associated with significant peri-operative complication. • Sequelae of peri-operative morbidity may contribute to decreased survival. • Bowel resection may be a surrogate for worse tumor molecular subtype.
Objectives To evaluate the impact of bowel resection at the time of interval cytoreductive surgery on survival. Methods We identified patients with advanced ovarian cancer who underwent neoadjuvant chemotherapy and interval cytoreductive surgery between 2008 and 2018 from a single-institution tumor registry. Kaplan-Meier survival analysis and Cox proportional hazards models were performed comparing patients who underwent bowel resection to those who did not. Results Of 158 patients, 43 (27%) underwent bowel resection. Rates of optimal (95%) and sub-optimal (5%) resection did not differ with bowel resection. Patients that required bowel resection had worse three-year survival (43% vs. 63%), even after adjusting for confounding variables of age, stage, number of neoadjuvant cycles, R0 resection, and ASA score (HR 2.27, p