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Role of Video-Assisted Thoracoscopy in Advanced Ovarian Cancer: A Literature Review
  1. Julián Di Guilmi, MD,
  2. Gloria Salvo, MD,
  3. Reza Mehran, MD,
  4. Anil K. Sood, MD,
  5. Robert L. Coleman, MD,
  6. Karen H. Lu, MD,
  7. Ara Vaporciyan, MD and
  8. Pedro T. Ramirez, MD
  1. * Department of Gynecology, Hospital Británico de Buenos Aires, Buenos Aires, Argentina;
  2. Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; and
  3. Department of Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
  1. Address correspondence and reprint requests to Pedro T. Ramirez, MD, Department of Gynecologic Oncology and Reproductive Medicine, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. E-mail: peramire{at}mdanderson.org.

Abstract

Abstract Tools that accurately predict the presence of metastatic ovarian cancer in the pleura are limited. Thus, we sought to summarize the current literature on video-assisted thoracoscopic surgery (VATS) and its applicability in patients with advanced ovarian cancer. A total of 187 patients with suspected ovarian cancer who underwent the VATS procedure were identified for this analysis. The median patient age was 59.4 years (range, 20.3–83 years). The median operative time for VATS was 32 minutes (range, 5–65 minutes). In 89 patients (48%), VATS revealed macroscopic disease in the pleural cavity. After VATS, 44 patients underwent neoadjuvant chemotherapy, and the remaining 143 patients underwent primary cytoreductive surgery. Video-assisted thoracoscopic surgery led to a change in disease stage or management in 76 patients (41%). Among patients with pleural effusions, VATS revealed pleural disease in 57% of patients, and 73% of patients with positive pleural cytology had evidence of pleural disease at the time of VATS. In addition, 23.5% of patients with negative pleural cytology had evidence of pleural disease at the time of VATS. Prospective trials are needed to accurately evaluate the impact of VATS on disease-free and overall survival in patients with advanced ovarian cancer. Video-assisted thoracoscopic surgery can help determine which patients are ideal candidates for surgical cytoreduction.

  • VATS
  • Ovarian cancer
  • Surgery

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Footnotes

  • The authors declare no conflicts of interest.

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