Surgical resection of recurrent upper abdominal cervical cancer: A case report and review of the literature

Surgical Treatment of an Isolated Omental Cervical Cancer Recurrence: Report of a Case and Review of the Literature

Aims and Background

Recurrent cervical cancer has traditionally been associated with a dismal prognosis. Historically, patients who developed distant metastases from cervical cancer were not considered eligible for surgical resection; only palliative treatment options are available, generally consisting of chemo- and/or radiotherapy. Metastases usually appear in the liver, lung or lymph nodes. The abdominal cavity is a quite unusual site of recurrence and the disease usually has multiple foci. For this reason, peritoneal involvement by cervical cancer is considered a contraindication to local treatment.

Methods and Study Design

We report the first case of a 30-year-old woman with isolated intra-abdominal cervical cancer recurrence diagnosed with 18F-FDG PET/CT, successfully surgically treated.

Results

Histopathological analysis confirmed the tumor to be an omental relapse of squamous cervical cancer previously treated with anterior pelvic exenteration and platinum based chemotherapy. The patient underwent adjuvant treatment with 3 cycles of topotecan and has remained free of disease during the 4 years of follow-up.

Conclusions

In selected cases with isolated recurrences, a surgical resection may provide a long term complete remission in recurrent cervical cancer patients.

Primary debulking surgery for metastatic cervical adenocarcinoma: A case report

•The case presented is that of a primary debulking surgery for presumed ovarian cancer.•Final pathology revealed diffusely metastatic endocervical adenocarcinoma.•After primary chemotherapy, the patient has remained disease-free 30 months after surgery.

Hepatic resection during cytoreductive surgery for primary or recurrent epithelial ovarian cancer

PURPOSE

Surgical cytoreduction remains a cornerstone in the management of patients with advanced and recurrent epithelial ovarian cancer. Parenchymal liver metastases determine stage VI disease and are commonly considered a major limit in the achievement of an optimal cytoreduction. The purpose of this manuscript was to discuss the rationale of liver resection and the morbidity related to this procedure in advanced and recurrent ovarian cancer.

METHODS

A search of the National Library of Medicine's MEDLINE/PubMed database until March 2015 was performed using the keywords: "ovarian cancer," "hepatic," "liver," and "metastases."

RESULTS

In patients with liver metastases, hepatic resection is associated with a similar prognosis as stage IIIC patients. The length of the disease-free interval between primary diagnosis and occurrence of liver metastases, as well as residual disease after resection, is the most important prognostic factors. In addition, the number of liver lesions, resection margins, and the gynecologic oncology group performance status seem to play also an important role in determining outcome.

CONCLUSIONS

In properly selected patients, liver resections at the time of cytoreduction increase rates of optimal cytoreduction and improve survival in advanced-stage and recurrent ovarian cancer patients.