Ane Gerda Z Eriksson1, Ashley Graul1, Miao C Yu1, Anthony Halko1, Dennis S Chi2, Oliver Zivanovic2, Ginger J Gardner2, Yukio Sonoda2, Richard R Barakat2, Nadeem R Abu-Rustum2, Mario M Leitao3. 1. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. 2. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. 3. Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. Electronic address: leitaom@mskcc.org.
Abstract
OBJECTIVES: To assess the perioperative outcomes of minimal access surgery (MAS) in secondary surgical cytoreduction (SSCR) for recurrent epithelial ovarian cancer (ROC); to compare oncologic outcomes with laparotomy (LAP). METHODS: Using an institutional database, we identified all patients with ROC undergoing SSCR from 1/5/09-6/14/14. Selection for MAS or LAP was based on surgeon preference. To minimize selection bias, preoperative imaging was reviewed for all LAP cases. In this manner, we identified potential MAS candidates, who were used in the comparison. Intent-to-treat analyses were undertaken using statistical testing. RESULTS: 170 cases were identified (131 LAP, 8 LSC, 31 RBT). 68/131 (52%) LAP cases were deemed potential candidates for MAS. Feasibility analyses included 68 LAP and 39 MAS cases. Six (15%) MAS cases were converted to LAP. Median age, BMI, operative time did not differ significantly between the groups. Complete gross resection was achieved in 37/39 (95%) MAS, 63/68 (93%) LAP (P=1.0). Median estimated blood loss was 50cm3 (range, 5-500) MAS, 150cm3 (range, 0-1500) LAP (P=0.001). Median length of stay was 1day (range, 0-23) MAS, 5days (range, 1-21) LAP (P<0.001). Complications occurred in 3/39 (8%) MAS, 15/68 (22%) LAP (P=0.06). The 2-year progression-free survival was 56.1% (SE 9%) MAS, 63.5% (SE 6%) LAP (P=1.0). The 2-year overall survival was 92.2% (SE 5.4%) MAS, 81.4% (SE 5.5%) LAP (P=0.7). CONCLUSIONS: MAS for SSCR is feasible in properly selected cases. MAS is associated with favorable perioperative outcomes and similar oncologic outcomes, compared to LAP.
OBJECTIVES: To assess the perioperative outcomes of minimal access surgery (MAS) in secondary surgical cytoreduction (SSCR) for recurrent epithelial ovarian cancer (ROC); to compare oncologic outcomes with laparotomy (LAP). METHODS: Using an institutional database, we identified all patients with ROC undergoing SSCR from 1/5/09-6/14/14. Selection for MAS or LAP was based on surgeon preference. To minimize selection bias, preoperative imaging was reviewed for all LAP cases. In this manner, we identified potential MAS candidates, who were used in the comparison. Intent-to-treat analyses were undertaken using statistical testing. RESULTS: 170 cases were identified (131 LAP, 8 LSC, 31 RBT). 68/131 (52%) LAP cases were deemed potential candidates for MAS. Feasibility analyses included 68 LAP and 39 MAS cases. Six (15%) MAS cases were converted to LAP. Median age, BMI, operative time did not differ significantly between the groups. Complete gross resection was achieved in 37/39 (95%) MAS, 63/68 (93%) LAP (P=1.0). Median estimated blood loss was 50cm3 (range, 5-500) MAS, 150cm3 (range, 0-1500) LAP (P=0.001). Median length of stay was 1day (range, 0-23) MAS, 5days (range, 1-21) LAP (P<0.001). Complications occurred in 3/39 (8%) MAS, 15/68 (22%) LAP (P=0.06). The 2-year progression-free survival was 56.1% (SE 9%) MAS, 63.5% (SE 6%) LAP (P=1.0). The 2-year overall survival was 92.2% (SE 5.4%) MAS, 81.4% (SE 5.5%) LAP (P=0.7). CONCLUSIONS: MAS for SSCR is feasible in properly selected cases. MAS is associated with favorable perioperative outcomes and similar oncologic outcomes, compared to LAP.
Authors: M Loverro; R Ergasti; C Conte; V Gallitelli; D Nachira; G Scaglione; A Fagotti; G Scambia; V Gallotta Journal: Ann Surg Oncol Date: 2022-01-08 Impact factor: 5.344
Authors: Augusto Pereira; Javier F Magrina; Paul M Magtibay; Joao Siufi Neto; Daniela F S Siufi; Yu-Hui H Chang; Tirso Perez-Medina Journal: Cancers (Basel) Date: 2022-07-22 Impact factor: 6.575
Authors: Jolijn W Groeneweg; Joline F Roze; Wouter B Veldhuis; Jelle P Ruurda; Cornelis G Gerestein; Ronald P Zweemer Journal: Gynecol Oncol Rep Date: 2021-05-07