목적: To evaluate the survival impact of low anterior resection (LAR) in patients with epithelial ovarian cancer (EOC) grossly confined to pelvis. 방법: A total of 397 patients who underwent primary staging operation for the treatment of stage II-IIIA EOC was retrospectively reviewed: 116 (29.2%) IIA, 212 (53.4%) IIB, 30 (7.6%) IIIA1, and 39 (9.8%) IIIA2. Patients who had grossly enlarged retroperitoneal lymph nodes positive for metastatic carcinoma were excluded. Total study population comprised three groups according to the presence of gross tumor on intrapelvic rectosigmoid colon and bowel resection: no-tumor/non-LAR group (n=305, 76.8%), tumor/non-LAR group (n=68, 17.1%), and tumor/LAR group (n=24, 6.1%). Survival rates were compared between the groups. 결과: Median follow-up was 36 months (range 0-260 months). Five-year progression-free survival (PFS) of stage IIA, IIB, IIIA1, and IIIA2 were 65.1%, 61.0%, 50.4%, and 45.5%, respectively. There was no survival difference between no-tumor (n=305) and tumor (n=92) groups. All patients of tumor/non-LAR group underwent tumorectomy and/or electrocoagulation. Survival difference was not observed between no-tumor/non-LAR group and tumor/non-LAR group (5-yr PFS, 60.4% vs.58.3%; p=0.530 and 5-yr overall survival [OS], 81.2% vs. 88.0%; p=0.985) even though complete cytoreduction rate was significantly higher in no-tumor/non-LAR group than tumor/non-LAR group (p<0.001). There was no significant survival difference between tumor/LAR and tumor/non-LAR groups (5-yr PFS, 62.5% vs. 58.3%; p=0.787 and 5-yr OS, 63.5% vs. 88.0%; p=0.078). Age, histologic type, optimal cytoreduction rate (residual tumor size≤1cm), and cycle number of adjuvant chemotherapy were not different between the groups of comparisons. Postoperative ileus ≥grade 2 was more frequently observed in LAR group than non-LAR group (13.6% vs. 3.2%; p=0.013). 결론: Survival benefit of LAR does not appear to be significant in the patients with grossly pelvis-confined EOC where post-tumorectomy site on intrapelvic rectosigmoid colon might not be considered as residual tumor.