Laparoscopic debulking surgery in the management of advanced ovarian cancer after neoadjuvant chemotherapy

Abstract

Objective: To evaluate the feasibility and the effect of the laparoscopic debulking surgery for treatment advanced ovarian cancer after neoadjuvant chemotherapy.

Methods: We performed a retrospective review of laparoscopic approach in patients with histologically confirmed epithelial ovarian cancer (International Federation of GynaecologyObstetrics stages IIIC-IV) who received 3 courses of neoadjuvant chemotherapy, from January 2012 to January 2017, at the Department of Obstetrics and Gynaecology, Hue Central Hospital.

Results: A total of 30 patients were included. The median age was 50 years old (26 – 73), median body mass index was 24.5 kg/m2 (19 - 39). All patients had good clinical response after 3 cycles of neoadjuvant chemotherapy. Most women underwent a complete debulking surgery with no residual disease (56.6%). The median operating time was 152 minutes (70 - 335 minutes), the median blood loss was 70 mL (50-200 mL). The median number of removed pelvic lymph nodes was 15 (range, 13-25). There was 1 (3.3%) intraoperative complication and 2 (6.6%) postoperative short-term complications. The median length of hospital stay was 4 days (range, 3-13 days). The median follow-up was 15 months (range, 2-54 months). Twenty-six patients are free from recurrence at this time.

Conclusions: Laparoscopic cytoreduction when performed by experienced specialist were feasible and may decrease the impact of aggressive surgery in advanced ovarian cancer patients after neoadjuvant chemotherapy. The significant advantages of this approach are less invasive surgery, less blood loss during surgery, short recovery time.