Laparoscopic Splenectomy for Secondary Cytoreduction in Ovarian Cancer Patients With Localized Spleen Recurrence: Feasibility and Technique

Abstract

Study ObjectiveTo investigate the feasibility of laparoscopic splenectomy in patients with recurrent ovarian cancer with isolated spleen metastasis. Design(Canadian Task Force classification III). SettingTertiary referral centre in Rome, Italy. PatientsEight women with an isolated platinum-sensitive splenic relapse of ovarian cancer. InterventionBetween February 2013 and May 2015, 8 women with an isolated platinum-sensitive splenic relapse of ovarian cancer were submitted to laparoscopic splenectomy. Measurements and Main ResultsAll patients underwent laparoscopic splenectomy without conversion to an open approach. The median estimated intraoperative blood loss was 100 mL (range, 50–200 mL). The median operating room time was 200 minutes (range, 80–275 mL). No intraoperative complication occurred, and no intraoperative blood transfusions were required. The median length of hospital stay was 3 days (range, 2–5 days). Complete tumor resection was achieved in all patients. The median interval from surgery to adjuvant chemotherapy was 16 days (range, 14–24 days). After a median follow-up of 23 months (range, 6–32 months), no secondary recurrence or death of disease has been observed. ConclusionOur findings indicate that a laparoscopic approach for spleen removal is feasible in selected patients with a splenic relapse of ovarian cancer when performed in a tertiary referral center by a well-trained surgeon.