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539 Robotic interval debulking surgery for advanced epithelial ovarian cancer. current challenge or future direction? A systematic review
  1. Victoria Psomiadou,
  2. Anastasia Prodromidou,
  3. Alexandros Fotiou,
  4. Sofia Lekka and
  5. Christos R Iavazzo
  1. Metaxa Cancer Hospital, Piraeus, Greece; Metaxa Memorial Cancer Hospital; Department of Gynecologic Oncology


Introduction/Background Safety and efficacy of robotic interval debulking surgery (IDS) after treatment with neoadjuvant chemotherapy (NACT) in advanced epithelial ovarian cancer (EOC) was evaluated.

Methodology A systematic review of the literature was conducted.

Results We evaluated 102 patients in total. Perioperative outcomes were estimated as following: mean estimated blood loss ranged from 106.9 to 262.5 ml (mean± SD: 168±68 ml), mean operative time ranged from 164 to 312 min (mean± SD: 246±61 min), mean hospital stay was 2.4 days and postoperative blood transfusion rate was 19% (n=19/98). Regarding the oncological outcomes, 75patients received a R0 resection (complete cytoreduction), while by 21 women there was a residual disease ≤1 cm. Regarding complications, no intraoperative and 6 postoperative (14,6%) complications were recorded, with a 30-d mortality rate of 9.2% (n=9/98), whereas the laparotomy conversion rate was 9.2% (9/98) as well, mostly in the terms of achieving complete cytoreduction. During a median follow up period of 2 to 86 months (median 25.3 months), the median overall survival from 39.7 to 47.2 months and the progression free survival varied from 20.6 to 21.2 months. Recurrent disease was reported in 60 women (61%). Our results are in harmony (p=0.02) with those of the one study that presented significantly improved OS and PFS in the robotic arm compared to laparotomy (47.2 vs 37.8 vs 37.9, p=0.004 for OS and 20.6 vs 13.9 vs 11.9, p=0.005 for PFS, respectively).

Conclusion Robotic interval debulking surgery is a safe and efficient regarding the management of advanced ovarian cancer patients who receive neoadjuvant chemotherapy. The patients that are more eligible and could benefit from this treatment strategy should be specified through larger, double-blind randomized control trials.

Disclosures All authors declare no conflict of interest.

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