Objectives Compared with primary debulking surgery, treating ovarian cancer with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) results in similar outcomes, while showing significantly less surgical morbidity. To further reduce surgical morbidity, surgeons have followed NAC with minimally invasive Robotic (R-IDS).
Methods This single institution, retrospective study evaluated patients having R-IDS after NAC for newly diagnosed advanced stage (III or IV) ovarian cancers between 2006–2016. Outcomes were compared between these 16 Robotic IDS and 16 matched-cases of traditional Open laparotomy (O-IDS)
Results One conversion from planned R-IDS to O-IDS due to inability to adequately ventilate. Age for R-IDS was 57 (48–91) vs 66 (48–83) for O-IDS. Surgical data for R-IDS versus O-IDS showed: optimal cytoreduction 14/16 (87%) vs 15/16 (94%), intra-op blood transfusions 0/16 vs 4/16 (25%), operative time (136 min, 75–250) vs (206 min, 128–356), and blood loss 98 (25–250) vs 250 (50–600), length of stay 28 hours (21–216) vs 99 hours (67–247). Post-operatively for R-IDS there were no major complications, and no ICU admissions, while O-IDS had 5 wound complications, 1 pneumonia. Thirteen of R-IDS had comprehensive follow-up data allowing analysis of progression-free survival, which ranged from 4 to 32 months, with a median PFS 15 months, and 7/13 (54%) died of disease.
Conclusions The use of NAC before IDS has become more prevalent since publication of trials showing similar oncologic outcome to primary debulking with less morbidity. Our series supports feasibility of using a R-IDS to minimize surgical morbidity, while maintaining oncologic outcome.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.