Laparoscopic-assisted cytoreduction for primary advanced ovarian cancer: success, morbidity and survival.

Abstract

OBJECTIVE:

The purpose of this paper is to evaluate laparoscopic-assisted cytoreduction for primary advanced ovarian cancer: feasibility, morbidity, response to chemotherapy and survival.

METHODS:

All patients with presumed stage 3/4 primary ovarian cancer underwent attempted laparoscopic cytoreduction. All patients had CT evidence of omental metastasis and ascites. A five port (5-mm) transperitoneal approach was used. A bilateral salpingo-oophorectomy, supracervical hysterectomy and omentectomy were performed with the PlasmaKinetic (PK) cutting forceps. A laparoscopic 5-mm Argon-Beam Coagulator was used to coagulate tumor in the pelvis, abdominal peritoneum, intestinal mesentery, and diaphragm.

RESULTS:

Twenty-three cases (92%) were successfully cytoreduced laparoscopically without conversion to laparotomy. Median operative time was 2.3h and median blood loss was 340 cc. All tumors were debulked to less than 2 cm and 36% had no residual disease. Median length of stay was 1 day. Median VAS pain score was 4-discomforting. Six patients (24%) had post-operative complications, none grades 3-4. Median overall survival is 3.5 years.

CONCLUSION:

Laparoscopic-assisted cytoreduction for primary advanced ovarian cancer was successful, resulting in minimal morbidity, and acceptable survival.

• Authors: James Fanning, Emmanuel Yacoub, Rod Hojat
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 123 Issue 1 Pg. 47-9 (Oct 2011) ISSN: 1095-6859 [Electronic] United States
• PMID: 21741079 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Combined Modality Therapy
• Female
• Gynecologic Surgical Procedures (adverse effects, methods)
• Humans
• Laparoscopy (adverse effects, methods)
• Middle Aged
• Morbidity
• Neoplasm Staging
• Ovarian Neoplasms (drug therapy, pathology, surgery)
• Survival Rate
• Treatment Outcome