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Abstract
Introduction/Background Ovarian cancer is one of the most lethal gynecological malignancies. This is because early diagnosis is difficult, and it usually presents in advanced stages. In these cases, randomized controlled trials have indicated that neoadjuvant chemotherapy (NACT) followed by interval disease surgery (IDS) offers similar of oncological and survival outcomes than primary surgery, and tumor burden remains is the principal poor prognostic factor. Historically, the surgical approach for these patients was by an explorative laparotomy. The role of the minimal invasive surgery (MIS) remains unclear. Thus, the purpose of our study is to evaluate the application of robotic surgery.
Methodology A cohort retrospective study with prospectively collected data was performed including patients with advanced ovarian cancer who underwent to NACT and presented a radiological and serological favourable response and was possible to perform an optimal cytoreduction (R0) by robotic surgery. Clinicopathological and survival outcomes, including overall survival (OS) and disease-free survival (DFS), were collected and analized. We have compared this selected group of patients with a historical cohort that includes patients with similar response taxes who underwent to laparotomic surgery also obtaining an optimal cytoreduction.
Disease free survival kaplan-meier graphic
Results The study includes a total of 15 patients who performed a robotic surgery and 22 a laparotomic surgery. In the robotic surgery cohort, the DFS at 3 years was 60.0% (CI 95% 32.8–87.2%) and 9.1% (CI 95% 0–21.1%) in the laparotomic, although no statistically significant differences were found between them (Log-Rank test p 0.343). The OS at 3 years in the robotic surgery cohort was 92.0% (CI 95% 77.0–100%) and in the laparotomy group 52.7% (CI 95% 31.1–74.2%), also without significant differences (Log-Rank test p 0.225).
Overall survival kaplan-meier graphic
Conclusion Our study demonstrate that robotics surgery could be considered as an alternative cytoreduction option without worst survival outcomes respect laparotomic approach in highly selected patients.