Valerio Gallotta1, Fabio Ghezzi2, Enrico Vizza3, Anna Fagotti4, Marcello Ceccaroni5, Francesco Fanfani4, Vito Chiantera6, Alfredo Ercoli7, Cristiano Rossitto4, Carmine Conte4, Stefano Uccella2, Giacomo Corrado3, Giovanni Scambia4, Gabriella Ferrandina4. 1. Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gallottav@gmail.com. 2. Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. 3. Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy. 4. Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy. 5. Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, Sacred Heart Hospital, Negrar, Verona, Italy. 6. Gynecologic Oncology Unit, Fondazione "Giovanni Paolo II", Campobasso, Italy. 7. Department of Obstetrics and Gynecology Abano Terme Hospital, Padova, Italy.
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.
STUDY OBJECTIVE: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancerpatients 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 cancerpatients, 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 cancerpatients with limited carcinomatosis or lymph node involvement.