DOI: 10.25881/20728255_2021_16_3_112


Solovyov I.A.1, Tsypurdeeva A.A.2, Vasilchenko M.V.2, Grebenkov V.G.2

1 Mariinsky Hospital, St. Petersburg

2 S.M. Kirov Military medical academy, St. Petersburg


Ovarian cancer ranks third in the structure of onco-gynecological morbidity and leads in the structure of mortality in women. This situation is due to late diagnosis, as evidenced by the fact that more than 70.0% of patients are diagnosed with advanced forms of cancer at the initial treatment. Cytoreductive operations in ovarian cancer with the spread to neighboring pelvic organs, the anterior abdominal wall lead to changes in the area of surgical intervention, the ratio of anatomical structures and the need to modify the usual surgical approach.

The article presents a case of successful combined surgical treatment of recurrent ovarian cancer in a 20-year-old patient with metastasis to the anterior abdominal wall and invasion of the tumor into the colon. The presented clinical case of performing a combined operation for recurrent ovarian cancer with resection of the colon and anterior abdominal wall may contribute to the prolongation of survival in a young patient.

Keywords: ovarian cancer, recurrent ovarian cancer, cytoreductive surgery, optimal cytoreduction, polychemotherapy.


1. Kaprin AD, Starinsky VV, Petrova GV. Malignant neoplasms in Russia in 2017 (morbidity and mortality). Moscow, 2018. 250 p. (In Russ).

2. Peres LC, Cushing-Haugen KL, Köbel M, et al. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst. 2019; 111(1): 60-68. doi:10.1093/ jnci/djy071.

3. Henderson JT, Webber EM, Sawaya GF. Screening for Ovarian Cancer: Updated Evidence Repor t and Systematic Review for the US Preventive Services Task Force. JAMA. 2018; 319(6): 595-606. doi:10.1001/jama.2017.21421.

4. Armstrong DK, Alvarez RD, Bakkum-Gamez JN, et al. Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2021; 19(2): 191-226. doi:10.6004/jnccn.2021.0007.

5. du Bois A, Reuss A, Pujade-Lauraine E, Harter P, Ray-Coquard I, Pfisterer J. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer. 2009; 115(6): 1234-1244. doi:10.1002/cncr.24149.

6. Chi DS, Eisenhauer EL, Zivanovic O, et al. Improved progression-free and overall survival in advanced ovarian cancer as a result of a change in surgical paradigm. Gynecol Oncol. 2009; 114(1): 26-31. doi:10.1016/j.ygyno. 2009.03.018.

7. Harter P, Muallem ZM, Buhrmann C, et al. Impact of a structured quality management program on surgical outcome in primary advanced ovarian cancer. Gynecol Oncol. 2011; 121(3): 615-619. doi:10.1016/j.ygyno.2011.02.014.

8. Harter P, Sehouli J, Lorusso D, et al. A Randomized Trial of Lymphadenectomy in Patients with Advanced Ovarian Neoplasms. N Engl J Med. 2019; 380(9): 822-832. doi:10.1056/ NEJMoa1808424.

9. Chan JK, Urban R, Hu JM, et al. The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13918 patients. Br J Cancer. 2007; 96(12): 1817-1822. doi:10.1038/sj.bjc.6603803.

10. Paik ES, Lee YY, Shim M, et al. Timing and patterns of recurrence in epithelial ovarian cancer patients with no gross residual disease after primary debulking surgery. Aust N Z J Obstet Gynaecol. 2016; 56(6): 639-647. doi:10.1111/ajo.12529.

11. Fotiou S, Aliki T, Petros Z, et al. Secondary cytoreductive surgery in patients presenting with isolated nodal recurrence of epithelial ovarian cancer. Gynecol Oncol. 2009; 114(2): 178-182. doi:10.1016/j.ygyno.2009.04.025.

12. Gadducci A, Cosio S, Zizioli V, et al. Patterns of Recurrence and Clinical Outcome of Patients With Stage IIIC to Stage IV Epithelial Ovarian Cancer in Complete Response After Primary Debulking Surgery Plus Chemotherapy or Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery: An Italian Multicenter Retrospective Study. Int J Gynecol Cancer. 2017; 27(1): 28-36. doi:10.1097/IGC. 0000000000000843.

13. Legge F, Petrillo M, Adamo V, Pisconti S, Scambia G, Ferrandina G. Epithelial ovarian cancer relapsing as isolated lymph node disease: natural history and clinical outcome. BMC Cancer. 2008; 8: 367. doi:10.1186/1471-2407-8-367.

14. Petrillo M, Fagotti A, Ferrandina G, et al. Ovarian cancer patients with localized relapse: clinical outcome and prognostic factors. Gynecol Oncol. 2013; 131(1): 36-41. doi:10.1016/j. ygyno.2013.06.020.

15. Blanchard P, Plantade A, Pagès C, et al. Isolated lymph node relapse of epithelial ovarian carcinoma: outcomes and prognostic factors. Gynecol Oncol. 2007; 104(1): 41-45. doi:10.1016/j.ygyno.2006.06.039.

16. Tyulyandin SA, Kolomiets LA, Morkhov KYu, Nechushkina VM, Pokataev IA, Tyulyandina AS, Urmancheeva AF, Khokhlova SV. Practical recommendations for the drug treatment of ovarian cancer, primary peritoneal cancer and fallopian tube cancer. Malignant tumors: Practical recommendations of RUSSCO. Moscow, 2018. 145-155 p. (In Russ).

17. Harter P, Sehouli J, Reuss A, et al. Prospective validation study of a predictive score for operability of recurrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. Int J Gynecol Cancer. 2011; 21(2): 289-295. doi:10.1097/IGC.0b013e31820 aaafd.

18. Jänicke F, Hölscher M, Kuhn W, et al. Radical surgical procedure improves survival time in patients with recurrent ovarian cancer. Cancer. 1992; 70(8): 2129-2136. doi: 10.1002/1097-0142(19921015)70:8<2129::aid-cncr2820700820 >;2-u.

19. Morris M, Gershenson DM, Wharton JT. Secondary cytoreductive surgery in epithelial ovarian cancer: nonresponders to first-line therapy. Gynecol Oncol. 1989; 33(1): 1-5. doi:10.1016/0090-8258(89)90593-3.

20. Harter P, du Bois A, Hahmann M, et al. Surgery in recurrent ovarian cancer: the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) DESKTOP OVAR trial. Ann Surg Oncol. 2006; 13(12): 1702-1710. doi:10.1245/s10434-006-9058-0.

21. Ferrero A, Ditto A, Giorda G, et al. Secondary cytoreductive surgery for isolated lymph node recurrence of epithelial ovarian cancer: a multicenter study. Eur J Surg Oncol. 2014; 40(7): 891-898. doi:10.1016/j.ejso.2013.11.026.

22. Nechushkina VM, Morkhov KYu,Tyulyandina AS, Nikolaenko LO, Tandelov RK, Rumyantsev AA, Abduragimova ZT, Gadzhiev AA, Kuznetsov VV, Nechushkin MI, Feinstein IA, Tyulyandin SA. Repeated cytoreductive interventions for ovarian cancer. Malignant tumours. 2018; 8(3): 42-46. (In Russ).

23. Machida H, Tokunaga H, Matsuo K, et al. Survival outcome and perioperative complication related to neoadjuvant chemotherapy with carboplatin and paclitaxel for advanced ovarian cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 2020; 46(5): 868-875. doi:10.1016/j.ejso.2019.11.520.

24. Uzan C, Morice P, Rey A, et al. Outcomes after combined therapy including surgical resection in patients with epithelial ovarian cancer recurrence(s) exclusively in lymph nodes. Ann Surg Oncol. 2004; 11(7): 658-664. doi:10.1245/ASO.2004.11.023.

25. Santillan A, Karam AK, Li AJ, et al. Secondary cytoreductive surgery for isolated nodal recurrence in patients with epithelial ovarian cancer. Gynecol Oncol. 2007; 104(3): 686-690. doi:10.1016/j.ygyno.2006.10.020.

For citation

Solovyov I.A., Tsypurdeeva A.A., Vasilchenko M.V., Grebenkov V.G. A clinical case of surgical treatment of recurrent ovarian cancer with implantation metastases in the anterior abdominal wall and invasion of the rectum in a young patient. Bulletin of Pirogov National Medical & Surgical Center. 2021;3(16):112-116. (In Russ.)