Article Text
Abstract
Introduction Complete cytoreduction represents a significant impact in OS for EOC patients. A large longitudinal incision is the standard access to achieve this goal. The aim of this study is to evaluate the role of MIS in interval debulking at a teaching institution.
Methods 126 HGS EOC patients referred for primary treatment in a referral cancer center, from 2014 and 2018, were included. Almost all patients underwent a laparoscopic diagnostic and peritoneal carcinomatosis index evaluation (PCI) before therapy. PS>2, PCI>20 and ASA>3 were indicators for neoadjuvant therapy.
Results 16 MIS and 79 laparotomic debulking procedures were identified. Interval debulking was proposed in 9 (23.6%) MIS and 29 (76.4%). Most patients were stage III and IV. A complete cytoreduction was achieved in all MIS patients. MIS had shorter hospital stay (1.5 versus 4.3 days), with no Grade 3 or more complications. Post-operative chemotherapy started in 29.7 days in MIS and 53.6 days in laparotomy. At a mean 24 months follow-up, 44.4% and 54.6% were free of disease at MIS and laparotomy groups, respectively.
Conclusion MIS may be an interesting approach to complete interval cytoreduction in very selected cases, with reduced complications and time to chemotherapy, with comparable DFS.