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SF021/#830 Minimally invasive secondary cytoreductive surgery for hepato-renal recess isolated recurrence of serous endometrial cancer in brca1 mutated patient
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  1. V Iacobelli1,
  2. F Taliente2,
  3. G Scambia3,
  4. A Fagotti3,
  5. F Fanfani3,
  6. GF Zannoni4,
  7. F Giuliante5 and
  8. V Gallotta6
  1. 1Università Cattolica del Sacro Cuore, Rome, Italy, Department of Woman and Child Health and Public Health, Woman Health Area, Rome, Italy
  2. 2Catholic University, Rome, Italy, General Surgery Department, Agostino Gemelli Irccs University Hospital Foundation, Hepatobiliary Surgery Unit, Foundation ‘policlinico Universitario A. Gemelli’, Irccs, Rome, Italy
  3. 3Università Cattolica del Sacro Cuore, Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli Irccs, Roma, Italy
  4. 4Fondazione Policlinico Universitario A. Gemelli, IRCCS, Gyneco-pathology and Breast Pathology Unit, Dipartimento Per La Salute Della Donna E Del Bambino E Della Salute Pubblica, Rome, Italy
  5. 5Hepatobiliary Surgery Unit, Foundation ‘Policlinico Universitario A. Gemelli’, IRCCS, Catholic University, Rome, Italy, General Surgery Department, Agostino Gemelli Irccs University Hospital Foundation, Rome, Italy
  6. 6Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Gynecologic Oncology, Rome, Italy

Abstract

Introduction This film shows the surgical management of a young BRCA1 mutated women affected by a recurrence of serous endometrial carcinoma (SEC). This aggressive subtype of endometrial cancer recurs in 30–80% of cases and shares most of its molecular features with serous ovarian cancer. The role of BRCA mutations in this setting is still not completely understood. The aim of this film was to show how a minimal invasive surgical approach is safe and feasible in selected patients.

Description In the video we present the case of a hepato-renal recess isolated recurrence of serous endometrial carcinoma. Patient positioning and port placement were critical to achieve an optimal exposure of the liver 6th segment and the Morison’s pouch. An extensive removal of visceral adhesions was performed and the metastasis was then exposed. The tumor infiltrated the liver parenchyma for less than 2 cm. A superficial wedge resection was executed until complete removal of the lesion. The procedure has been performed in 90 minutes. Post-operative course was unremarkable and the patient was discharged on post-operative day 3. The patient was able to resume her oral PARP inhibitor after 10 days. Histopathology report confirmed the metastatic localization of a high-grade serous cancer.

Conclusions Potential benefits of minimally invasive approach include reduced blood loss, less pain, faster recovery and a short interval to chemotherapy. The personalised treatment of recurrent endometrial serous cancer should be guided by the molecular pattern of the disease and by the surgical skills with a multidisciplinary approach. video: https://www.dropbox.com/s/glhyzjy7na5l0ls/MINIMALLY%20INVASIVE%20SECONDARY%20CYTOREDUCTIVE%20SURGERY%20FOR%20HEPATORENAL%20RECESS%20ISOLATED%20RECURRENCE%20OF%20SEROUS%20ENDOMETRIAL%20CANCER%20IN%20BRCA1%20MUTATED%20PATIENT.mp4?dl=0

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