Laparoscopic splenectomy for first single-site relapse of ovarian cancer

Abstract

: Ovarian cancer is an highly aggressive disease and, despite complete surgical cytoreduction and adjuvant chemotherapy, women with this diagnosis usually develop recurrent disease. Platinum-sensitive recurrence can be treated either with secondary cytoreductive surgery (SCS) plus platinum-based chemotherapy or with chemotherapy alone. Patients with isolated splenic metastasis, are relatively rare and could benefit from a minimally invasive approach without compromising survival. In this setting, the advantages of laparoscopy in terms of reduced morbidity, faster recovery, and better cosmetic outcomes are positively reflected on the patient “recurrence experience”, lightening its burden with a potential positive impact on their quality of life. We present the case of a 53-year-old woman with isolated parenchymal splenic recurrence of high-grade serous ovarian cancer that was treated with laparoscopic splenectomy, using an “anterior approach”. Perioperative outcomes of the reported case were superimposable to the open technique, with an estimated blood loss of 50 mL and an operative time of 150 minutes. At 25 months of follow-up, the patient showed no evidence of disease. This study aims to show a step-by-step approach to laparoscopic splenectomy during SCS. In conclusion we showed that, in the hands of an experienced surgeon and through a meticulous surgical technique, laparoscopic splenectomy for recurrent ovarian cancer is feasible and safe.