Abstract
BackgroundSurgery remains the cornerstone of treatment in ovarian cancers with the aim to achieve a complete cytoreduction with no macroscopic residual disease. The present study tries to assess the feasibility of laparoscopic optimal cytoreduction surgery (LOCS) in patients with advanced ovarian cancer (AOC) with low burden disease. MethodsA retrospective study of advanced ovarian cancer that underwent LOCS between 2010 and 2014 was done. Histologically confirmed epithelial or germ cell ovarian cancer who underwent either interval or primary cytoreduction surgery were included. ResultsIn all 40 patients with stage 3 ovarian cancers were included in the analysis. The median age was 50 years and the median BMI was 23 kg/m2. 39 patients had epithelial ovarian cancer (38 – serous, 1- endometrioid) and 1 patient had germ cell tumor. 23 were grade 3 and 17 were grade 2, with no patient in grade 1. Stage wise majority were stage IIIC (26 patients) followed by 3 in stage IIIA and 1 patient was stage IIIB.3 patients underwent primary cytoreduction (1- IIIA, 2- IIIB) and 37 patients received neoadjuvant chemotherapy (NACT) before surgery. 3 to 8 cycles of chemotherapy was given. On the final histopathological examination, complete response was seen in 7 patients. There was no intraoperative complication and one postoperative complication (2.5%). The median time to discharge was 5 days and the median time to start chemotherapy was 23 days. After a median follow up of 70 months 7 patients (17.5%) were lost to follow up. The overall survival was 48.3% and the recurrence-free survival was 27.2 %.19 patients recurred in the peritoneum and 5 patients had a nodal recurrence. ConclusionsLaparoscopic cytoreduction is feasible in patients with advanced-stage ovarian cancers, provided the disease burden permits optimal debulking, especially so if done in centers with experience in complex laparoscopic procedures. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.
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