Single-port or Classic Laparoscopy Compared With Laparotomy to Assess the Peritoneal Cancer Index in Primary Advanced Epithelial Ovarian Cancer

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• 作者：Lucie Bresson ; MD^a ; ^{l-bresson@o-lambret.fr" class="auth_mail" title="E-mail the corresponding author} ; Clemence Allard-Duclercq ; MD^a ; Fabrice Narducci ; MD^a ; Emmanuelle Tresch ; MSC^b ; Anne Lesoin ; MD^a ; Abesse Ahmeidi ; MD^c ; Eric Leblanc ; MD^a
• 关键词：Index of peritoneal carcinomatosis ; Ovarian cancer ; Resectability ; Single port
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：23
• 期：5
• 页码：825-832
• 全文大小：1037 K

文摘

A thorough laparoscopic assessment of the abdominopelvic cavity is a crucial step in the workup of primary advanced epithelial ovarian cancer to decide whether up-front cytoreductive surgery or neoadjuvant chemotherapy is the best option for adequate management. The purpose of our study was to compare single-port laparoscopy (SPL), classic laparoscopy (CL), and laparotomy using the peritoneal cancer index (PCI). Patients treated for Fédération Internationale de Gynécologie et d'Obstétrique stage 3 or 4 epithelial ovarian cancer were included in our study when they underwent a PCI evaluation by laparoscopy followed by laparotomy for cytoreduction. According to the technique used for the “noninvasive” procedure (SPL vs CL), 2 groups were compared retrospectively. The individual records of all patients were reviewed and analyzed. From 2011 to 2014, 21 patients were assessed for PCI by SPL plus laparotomy versus 21 by CL plus laparotomy. The clinicopathological features were similar in both groups (not significant [NS]), except for performance status >0, which was more frequent in the SPL group (39% vs 6%, p = .04). Quotation of PCI was possible for all patients. Nonbrowsing areas marked 3 procedures in the SPL group and 2 procedures in the CL group (NS). The mean PCI score and the score of each region assessed by SPL and CL were comparable with the evaluation by laparotomy (NS). Completeness of cytoreduction was achieved in 78% of cases in both groups (NS). SPL and widely mini-invasive procedures seem to be effective tools compared with laparotomy to adequately assess the resectability of a peritoneal carcinomatosis using the PCI.