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abstract/open access
Abstract
Objective: The purpose of this study was to evaluate
the feasibility and morbidity of total laparoscopic debulking surgery in
the treatment of advanced ovarian cancer after neoadjuvant
chemotherapy.
Methods/Materials: We performed a retrospective review
of laparoscopic approach in patients with histologically confirmed
epithelial ovarian cancer (International Federation of
GynaecologyObstetrics stages IIIC-IV) who received 3 courses of
neoadjuvant chemotherapy, from January 2010 to December 2014, at the
Gynaecologic Oncologic Unit, “Regina Elena” National Cancer Institute,
Rome, Italy.
Results: A total of 30 patients were included. The median age was 50 years (range, 26–73 years), median body mass index was 24.5 kg/m2 (range, 19–39 kg/m2).
All patients had good clinical response to 3 cycles of neoadjuvant
chemotherapy. All women underwent a complete debulking surgery with no
residual disease. The median operating time was 152 minutes (range,
70–335 minutes), the median blood loss was 70 mL (range, 50–200 mL). The
median number of removed pelvic lymph nodes was 15 (range, 13–25).
There was 1 (3.3%) intraoperative complication and 2 (6.6%)
postoperative short-term complications. The median length of hospital
stay was 4 days (range, 3–13 days). The median follow-up was 15 months
(range, 2–54 months). Twenty-six patients are free from recurrence at
the time of this report.
Conclusions: Laparoscopic cytoreduction in patients
with advanced ovarian cancer after neoadjuvant chemotherapy, when
performed by skilled surgeons, seems feasible and may decrease the
impact of aggressive surgery on high-morbidity patients, such as on
women after chemotherapy.
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