Objectives Primary therapy planning, meaning primary surgery vs. neoadjuvant chemotherapy (NACT), in suspected advanced ovarian cancer is a professional and logistical challenge. Prompt diagnostic laparoscopy in such patients should confirm the diagnosis by frozen section, assess operability and thus, avoid unnecessary laparotomies.
Methods Retrospective evaluation of 130 patients who presented in 2016–2020 with suspected advanced ovarian cancer (peritoneal carcinomatosis, ascites on average 1,5L).
Results In 2016–20, 82/130 patients (63%) underwent diagnostic laparoscopy; the others received either primary laparotomy, NACT, palliative chemotherapy, or best supportive care. 47% percent of the 82 patients were triaged to NACT, and 53% to primary surgery. The median time between initial presentation and laparoscopy was almost 8 days, the time from laparoscopy to 1st cycle of NACT was 14 days, and the time from laparoscopy to laparotomy was 15d. The rate of R0 resections in patients with primary surgery after laparoscopy was 84%.
Conclusions Diagnostic laparoscopy seems to be an efficient measure in the workup and treatment planning of patients with suspected advanced ovarian cancer. The times between first presentation and laparoscopy as well as between laparoscopy and NACT or primary laparotomy need improvement.
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