6533b7d0fe1ef96bd125b822

RESEARCH PRODUCT

Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series

Stefano UccellaFrancesco FanfaniGiovanni ScambiaGabriella FerrandinaValerio GallottaAnna FagottiFabio GhezziVito ChianteraEnrico VizzaCristiano RossittoAlfredo ErcoliGiacomo CorradoMarcello CeccaroniCarmine Conte

subject

Adultmedicine.medical_specialtymedicine.medical_treatmentLaparoscopic cytoreduction; Laparoscopy; Minimally invasive surgery; Ovarian cancer; Adult; Aged; Aged 80 and over; Carcinoma; Cytoreduction Surgical Procedures; Disease-Free Survival; Feasibility Studies; Female; Humans; Laparoscopy; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Neoplasm Recurrence Local; Ovarian Neoplasms; Retrospective Studies; Young AdultGynecologic oncologyDisease-Free SurvivalLaparoscopic cytoreduction Laparoscopy Minimally invasive surgery Ovarian cancerYoung Adult03 medical and health sciences0302 clinical medicineMinimally invasive surgeryOvarian cancerCytoreduction Surgical Procedures80 and overmedicineCarcinomaHumansLymph nodeSurvival rateAgedRetrospective StudiesAged 80 and overOvarian Neoplasms030219 obstetrics & reproductive medicinebusiness.industryCarcinomaObstetrics and GynecologyRetrospective cohort studyCytoreduction Surgical ProceduresMiddle Agedmedicine.diseaseSurgeryNeoplasm Recurrencemedicine.anatomical_structureLocalLaparoscopic cytoreductionLymphatic Metastasis030220 oncology & carcinogenesisFeasibility StudiesFemaleLaparoscopyLymphadenectomyLymph NodesNeoplasm Recurrence LocalbusinessOvarian cancer

description

Abstract Study Objective To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. Design Retrospective cohort study (Canadian Task Force classification II-2). Setting Multi-institutional study performed in 6 referral gynecologic oncology units. Patients Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach. Interventions All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction. Measurements and results Sixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6 -55 months); 15 (21.7%) patients developed recurrence. Conclusion The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.

yearjournalcountryeditionlanguage
2016-01-01Journal of Minimally Invasive Gynecology
https://doi.org/10.1016/j.jmig.2016.01.029