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2022-RA-1542-ESGO ‘Things have changed’. Laparoscopic cytoreduction for advanced and recurrent ovarian cancer: The experience of a referral center on 108 patients
  1. Marcello Ceccaroni1,
  2. Susan Dababou2,
  3. Giovanni Roviglione1,
  4. Francesco Bruni1,
  5. Martina Venier3,
  6. Roberto Clarizia1,
  7. Carlotta Zorzi1,
  8. Daniele Mautone1,
  9. Matteo Salgarello4,
  10. Giulia Mantovani1,
  11. Lorenza Driul3,
  12. Stefania Gori5 and
  13. Stefano Uccella2
  1. 1Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, IRCCS Sacro Cuore ‘Don Calabria’ Hospital, Negrar, Verona, Italy
  2. 2ObstetricsandGynecology, University of Verona, Verona, Italy
  3. 3Clinic of Obstetrics and Gynecology, University of Udine, Academic Hospital of Udine, Udine, Italy
  4. 4Department of Nuclear Medicine, IRCCS Sacro Cuore ‘Don Calabria’ Hospital, Negrar, Verona, Italy
  5. 5Department of Medical Oncology, IRCCS Sacro Cuore ‘Don Calabria’ Hospital, Negrar, Verona, Italy


Introduction/Background To investigate the efficacy and safety of laparoscopic cytoreduction surgery for primary and recurrent ovarian cancer in a strictly selected group of patients.

Methodology From June 2008 to January 2020, FIGO stage IIIA-IV advanced ovarian cancer(AOC) patients were rigorously selected for laparoscopic primary (PDS), interval (IDS), or secondary debulking surgeries (SC). The primary endpoint was optimal cytoreduction, defined as residual tumor (RT) less than 1 cm. The secondary endpoints, safety and long-term results, were investigated every three months for the first two years, then every six months.

Results 108 patients with AOC were selected to undergo laparoscopic PDS (40 patients), IDS (44 patients), and SC (24 patients) surgeries. Optimal cytoreduction (RT=0) was obtained in 96%, 89%, and 88% of patients after SC, IDS, and PDS, respectively. Early post-operative complications occurred in 19% of cases, with 7% requiring a reintervention. One patient died of respiratory failure in the immediate post-operative period. Late postoperative complications occurred in 15%, 7%, and 4% of cases following PDS, IDS, and SC. The recurrence rate observed was 37% after laparoscopic optimal cytoreduction with a median observation time of 25 months. The overall survival (OS) at three and five years was 84% and 67% after PDS, and 66% and 32% after IDS. Three-year disease-free survival (DFS) was 48% and 51% after PDS and IDS, respectively.

Conclusion Minimal invasive laparoscopic surgery for AOC is feasible in strictly selected patients with high rates of optimal cytoreduction, satisfactory peri-operative morbidity, and encouraging survival outcomes.

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