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Abstract
Introduction/Background The role of secondary cytoreductive surgery (SCS) in cases of recurrent ovarian cancer has been debated. Recent studies have shown that optimal secondary debulking can improve overall and progression-free survival, but incomplete debulking may cause worse prognosis compared with no surgery. Therefore, optimal pre-operative planning is crucial regarding the possibility for complete resection. Pre-operative planning using Virtual 3D imaging has made advancements in many surgical fields, but no data exists in ovarian cancer surgery. We aimed to investigate cases in which use of pre-operative 3-D modeling was made prior to SCS.
Methodology A retrospective study performed in a single university medical center, identifying patients with recurrent ovarian cancer that underwent SCS between 2017–2022, comparing patients in which pre-operative 3D imaging was used (Group A), and those in which it was not (Group B). For both groups we described demographic and clinical data, and data regarding the outcomes of their SCS.
A 71 year old patient with recurrence of ovarian cancer. Tumor involving left Kidney and Pelvic mass involving the rectum. Frontal, Lateral and Inferior views (Tumor – in green)
Results Between 2017–2022, 84 patients were identified to have recurrence of ovarian cancer. Of these, 16 patients (19%) were taken for SCS. Six had preoperative 3D imaging and 10 did not. Age and stage at diagnosis were similar among groups. Median interval since first debulking was 54.4 (IQR 36.2–96) months vs. 63 (IQR 49.5–85) months for groups A and B, respectively.
When taken for surgery, diagnostic laparoscopy was used for 5/6 (83%) in group A compared to 6/10 (60%) in group B. Patients in group A had longer surgery (5 hours vs 3.75 respectively), but only 50% (5/10) in group B had a favorable surgical outcome of no residual disease in comparison to 6/6 (100%) in group A.
Conclusion Using 3-D imaging when planning secondary reductive surgery is feasible, and may have better surgical outcomes, to be further evaluated with future prospective studies.
Disclosures We have no disclosures