Ovarian cancer: MIS effective for interval cytoreduction after NACT

  • Brown J & al.
  • J Minim Invasive Gynecol
  • 18 Sep 2018

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In patients with advanced ovarian cancer, interval cytoreduction with minimally invasive surgery (MIS) yields higher complete and optimal resection rates vs laparotomy after neoadjuvant chemotherapy (NACT).
  • MIS was associated with less blood loss, lower transfusion rate, and shorter length of hospital stay.

Why this matters

  • Findings warrant larger prospective trials to confirm the importance of MIS in advanced disease.

Study design

  • 157 consecutive patients with stage III-IV epithelial ovarian, tubal, or peritoneal cancer underwent interval cytoreduction with MIS (n=53) or laparotomy (n=104) after at least 1 NACT cycle.
  • Funding: None disclosed.

Key results

  • Complete resection was achieved in 60.4% of patients in the MIS vs 42.3% in the laparotomy group.
  • Optimal cytoreduction was achieved in 96.3% vs 82.7% of patients, respectively (P=.02).
  • Patients undergoing MIS had significantly lower estimated blood loss (156 vs 278 mL; P<.001 fewer intraoperative transfusions vs p=".006)," and shorter hospital stay days>
  • Operative time was significantly longer in the MIS group (171 vs 150 minutes; P=.007).
  • No significant difference was observed in postoperative complications, ICU stay, readmission rates, PFS, or OS.

Limitations

  • Retrospective study.

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