Do Bilateral Oophorectomy with Hysterectomy and Omentectomy Improve Epithelial Ovarian Cancer Survival Rate Compared with Bilateral Oophorectomy Only?
Abstract
Due to the large number of affected women and poor prognosis of epithelial ovarian cancer (EOC), improving the treatment methods for epithelial ovarian cancer patients becomes a research priority to increase survival length and post-surgical quality of life. In this study, we used data from the California Cancer Registry to examine if complete surgery with bilateral (salpingo-)oophorectomy, abdominal hysterectomy, and omentectomy improve survival rates for early and advanced stage epithelial ovarian cancer. We employed Kaplan-Meier survival analysis and found that for early stage epithelial ovarian cancer, neither hysterectomy nor omentectomy could improve epithelial ovarian cancer survival. Patients who received complete surgery did not have significantly higher five-year survival rate compared to patients who received bilateral (salpingo-) oophorectomy only. Considering the aggressiveness and the effectiveness, complete surgery was not the best approach for early stage EOC patients. For advanced stage EOC patients, bilateral (salpingo-) oophorectomy with hysterectomy revealed a higher but non-significant five-year survival rate compared to bilateral (salpingo-) oophorectomy only. Complete surgery group had a significantly higher five-year survival rate compared to bilateral (salpingo-) oophorectomy with omentectomy. Together these suggested that hysterectomy in addition to bilateral (salpingo-) oophorectomy was essential for improving advanced stage EOC five-year survival. However, omentectomy did not show significant effect on EOC five-year survival. Complete surgery group had a five-year survival rate similar to that of the bilateral (salpingo-) oophorectomy with hysterectomy group. Again, considering the aggressiveness and the effectiveness, complete surgery was not the best approach for advanced stage EOC patients.