Introduction/Background Randomized controlled trials have consistently demonstrated that neoadjuvant chemotherapy followed by interval debulking surgery and subsequent chemotherapy yields comparable oncological outcomes in ovarian cancer when juxtaposed with primary surgery. Traditionally, explorative laparotomy served as the standard surgical approach. However, the role of minimal invasive surgery techniques remains shrouded in uncertainty and controversy. Consequently, the primary objective of our study is to scrutinize the application of robotic surgery within this patient cohort.

Methodology A prospective observational study was conducted, involving patients with advanced ovarian cancer who underwent neoadjuvant chemotherapy. These individuals exhibited a comprehensive radiological response, as evidenced by either the absence of disease visualization or mild ovarian hypermetabolism in PET-CT, coupled with a complete serological response, denoted by a CA125 level lower than 35, following chemotherapy. Subsequent to this, all enrolled patients underwent interval debulking surgery utilizing a robotic approach.

Results The study encompassed a cohort of 14 patients. Among these, 6 (42.8%) exhibited no macroscopic disease upon laparoscopic evaluation. Among the patients with residual disease, 5 (35.7%) presented omental implants smaller than 2 cm, 2 (12.2%) displayed residual tumors in the ovaries, and 1 (7.1%) had pathological paraaortic lymph nodes. Notably, the robotic approach was successfully employed in all cases, allowing for the removal of the tumor burden and achieving optimal surgery (R0) in every instance. Notably, only two postoperative complications were identified. These included a bladder lesion requiring intraoperative repair. Furthermore, one case of vaginal bleeding, attributed to a tear, was successfully addressed through suturing. Regarding survival outcomes, the three-year Disease-Free Survival (DFS) rate was 65.1% (95% CI 36.9–93.4%), while the five-year Overall Survival (OS) rate reached 83.1% (95% CI 61.5–100%).

Conclusion Our study findings suggest that robotic surgery may be regarded as a viable alternative for cytoreduction, exhibiting. This holds particularly true for a carefully selected subgroup of patients.

Disclosures No conflicts of interest to disclaim.