The safety and efficacy of laparoscopic surgical staging and debulking of apparent advanced stage ovarian, fallopian tube, and primary peritoneal cancers.

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Output type: Journal article

Author list: Nezhat, DeNoble, Liu, Cho, Brown, Chuang, Gretz, Saharia

Publisher: Society of Laparoendoscopic Surgeons

Publication year: 2010

Volume number: 14

Issue number: 2

Start page: 155

End page: 68

Number of pages: -86

ISSN: 1086-8089

Languages: English-Great Britain (EN-GB)

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Open access status: hybrid

Full text URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043561/pdf/jsls-14-2-155.pdf

Abstract

OBJECTIVES\nTo describe our experience with laparoscopic primary or interval tumor debulking in patients with presumed advanced ovarian, fallopian tube, or peritoneal cancers.\nMETHODS\nThis is a retrospective analysis of a prospective case series. Women with presumed advanced (FIGO stage IIC or greater) ovarian, fallopian tube, or primary peritoneal cancers deemed appropriate candidates for laparoscopic debulking by the primary surgeon(s) were recruited.\nRESULTS\nThe study comprised 32 patients who underwent laparoscopic evaluation. Seventeen underwent total laparoscopic primary or interval cytoreduction, with 88.2% optimal cytoreduction. Eleven underwent diagnostic laparoscopy and conversion to laparotomy for cytoreduction, with 72.7% optimal cytoreduction. Four patients had biopsies, limited cytoreduction, or both. In the laparoscopy group, 9 patients have no evidence of disease (NED), 6 are alive with disease (AWD), and 2 have died of disease (DOD), with mean follow-up time of 19.7 months. In the laparotomy group, 3 patients are NED, 5 are AWD, and 3 are DOD, with mean follow-up of 25.8 months. Estimated blood loss and length of hospital stay were less for the laparoscopy group (P=0.008 and P=0.03), while operating time and complication rates were not different. Median time to recurrence was 31.7 months for the laparoscopy group and 21.5 months for the laparotomy group (P=0.3).\nCONCLUSIONS\nLaparoscopy can be used for diagnosis, triage, and debulking of patients with advanced ovarian, fallopian tube, or primary peritoneal cancer and is technically feasible in a well-selected population.

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