Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series

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• 作者：Valerio Gallotta ; MD^a ; ^{gallottav@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Fabio Ghezzi ; MD^b ; Enrico Vizza ; MD^c ; Anna Fagotti ; MD^a ; Marcello Ceccaroni ; MD^d ; Francesco Fanfani ; MD^a ; Vito Chiantera ; MD^e ; Alfredo Ercoli ; MD^f ; Cristiano Rossitto ; MD^a ; Carmine Conte ; MD^a ; Stefano Uccella ; MD^b ; Giacomo Corrado ; MD^c ; Giovanni Scambia ; MD^a ; Gabriella Ferrandina ; MD^a
• 关键词：Laparoscopic cytoreduction ; Laparoscopy ; Minimally invasive surgery ; Ovarian cancer
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：23
• 期：4
• 页码：590-596
• 全文大小：349 K

文摘

To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement.

Design

Retrospective cohort study (Canadian Task Force classification II-2).

Setting

Multi-institutional study performed in 6 referral gynecologic oncology units.

Patients

Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach.

Interventions

All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction.

Measurements and results

Sixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6 -55 months); 15 (21.7%) patients developed recurrence.

Conclusion

The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.