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.

absSec_2">Design

abspara0015">Retrospective cohort study (Canadian Task Force classification II-2).

absSec_3">Setting

abspara0015a">Multi-institutional study performed in 6 referral gynecologic oncology units.

absSec_4">Patients

abspara0015b">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.

absSec_5">Interventions

abspara0015c">All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction.

absSec_6">Measurements and results

abspara0020">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.

absSec_7">Conclusion

abspara0025">The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.