Incorporating laparoscopic interval cytoreductive surgery for advanced ovarian cancer-lessons learnt

Clinical Surgical Oncology Pub Date : 2023-11-01 DOI:10.1016/j.cson.2023.100028

Yael Naaman , Deborah Neesham , Antonia Jones , Rosemary McBain , Tom Cade , Orla McNally

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Abstract

Objective

To assess the utility of laparoscopy for interval cytoreductive surgery (CRS) in patients with advanced ovarian cancer after Neo-Adjuvant Chemotherapy (NACT).

Methods

A retrospective cohort study of interval CRS by laparoscopy in patients with advanced epithelial ovarian cancer treated at a single tertiary gynaecological cancer centre between October 2017 and September 2020.

Results

86 patients had interval CRS by the laparoscopic route during the study period. The optimal cytoreduction rate (R < 1 cm) was 92%, and complete cytoreduction rate with no residual disease (R = 0) was 35%. The intra-operative complication rate was 8% and the estimated blood loss (EBL) was 90 ml. The post-operative complication rate was 15%, mostly grade I-II, and the median length of hospital stay was 3 days.

Conclusion

For most patients with advanced ovarian cancer after NACT, laparoscopic interval CRS is feasible and effective in achieving optimal cytoreduction while providing a favourable peri-operative outcome. In some cases, however, recourse to laparotomy will optimise complete macroscopic resection.

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结合腹腔镜间隔期细胞减少手术治疗晚期卵巢癌

目的探讨腹腔镜在晚期卵巢癌新辅助化疗(NACT)后间歇细胞减缩手术(CRS)中的应用价值。方法对2017年10月至2020年9月在某三级妇科癌症中心接受治疗的晚期上皮性卵巢癌患者进行腹腔镜间歇CRS回顾性队列研究。结果86例患者在研究期间经腹腔镜行间歇CRS。最佳细胞减少率(R <1 cm)为92%，无残留病变的完全细胞减少率(R = 0)为35%。术中并发症发生率为8%，估计出血量(EBL)为90ml。术后并发症发生率为15%，多为I-II级，中位住院时间为3天。结论对于大多数晚期卵巢癌NACT术后患者，腹腔镜间歇CRS是可行有效的，可达到最佳的细胞减少效果，同时提供良好的围手术期预后。然而，在某些情况下，求助于剖腹手术将优化完全的宏观切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Clinical Surgical Oncology

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