Introduction/Background Ovarian cancer is usually diagnosed in advanced stage. The goal of primary debulking is to achieve no residual disease (RD). Proper selection of candidates for complete debulking is crucial for the avoidance of suboptimal laparotomies. The aim of this study is to compare ‘Fagotti’ diagnostic laparoscopy and preoperative ‘Suidan’ criteria (age, ASA score, CA125, CT results) in the selection of patients for primary debulking.
Methodology We retrospectively reviewed the medical records of patients with advanced ovarian cancer that underwent ‘Fagotti’ diagnostic laparoscopy (January 2017 - January 2019) in our clinic.
Results 25 patients with advanced ovarian cancer underwent ‘Fagotti’ diagnostic laparoscopy, in order to decide their treatment plan. 7 patients were excluded from the study, because they did not meet the inclusion criteria. According to the preoperative predictive score, half of the patients (n=9) were assigned for primary debulking (PDS) (Group A) and the other half (n=9) for neoadjuvant chemotherapy (NACT) followed by interval debulking (IDS) (Group B). After ‘Fagotti’ diagnostic laparoscopy, the treatment plan changed in a total of 9 patients: 4 from Group A (from PDS to NACT+IDS) and 5 from Group B (from NACT+IDS to PDS), but with no statistically significant difference. From all patients (n=16) that underwent PDS or IDS, no case of suboptimal cytoreduction was documented (13 RD=0 and 3 RD<1). On the other hand, if the treatment plan was based only in the preoperative predictive score, 4 patients would have been offered an unnecessary suboptimal laparotomy and 5 patients would have been offered NACT, when they could have been offered a successful primary debulking.
Conclusion ‘Fagotti’ diagnostic laparoscopy continues to be the method of choice for the proper selection of patients for primary debulking, despite being an invasive technique.
Disclosure Nothing to disclose
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