TY - JOUR T1 - Laparoscopic management of advanced epithelial ovarian cancer after neoadjuvant chemotherapy: a phase II prospective multicenter non-randomized trial (the CILOVE study) JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1572 LP - 1578 DO - 10.1136/ijgc-2021-002888 VL - 31 IS - 12 AU - Christophe Pomel AU - Cherrif Akladios AU - Eric Lambaudie AU - Roman Rouzier AU - Gwennael Ferron AU - Fabrice Lecuru AU - Jean-Marc Classe AU - Virginie Fourchotte AU - Nicolas Paillocher AU - Arnaud Wattiez AU - Pierre-Francois Montoriol AU - Emilie Thivat AU - Marie Beguinot AU - Michel Canis Y1 - 2021/12/01 UR - http://ijgc.bmj.com/content/31/12/1572.abstract N2 - Objective The aim of this study was to explore the feasibility and safety of the laparoscopic approach after neoadjuvant chemotherapy among selected chemosensitive patients with advanced ovarian cancer.Methods The CILOVE study was a phase II prospective non-randomized multicenter study. It aimed to enroll 47 women with unresectable disease at the time of initial diagnosis (International Federation of Gynecology and Obstetrics (FIGO) stage IV and/or diffuse extensive carcinomatosis for advanced FIGO stage IIIC or patients unfit to withstand radical primary surgery), in response to chemotherapy and fit to undergo laparoscopy.Results Among the 48 patients enrolled in the trial, 44 (92%) patients underwent exploratory staging laparoscopy and, as a result, 41 patients were eligible for cytoreductive surgery. Among them, 32 were intended to be managed by laparoscopy and nine patients were managed by laparotomy. The conversion rate to laparotomy was 9.4% (3/32) and the reasons were multiple surgical adhesions (n=1), miliary carcinomatosis and adhesion to the intraperitoneal mesh (n=1), and poor laparoscopic evaluation of transverse colon involvement (n=1). All except one patient had optimal cytoreduction (97% complete cytoreduction, 3% incomplete cytoreduction (residual tumor <2.5 mm)). The median operative time was 267 min (range 146–415) and the median estimated blood loss was 150 mL (range 0–500). Two patients had intra-operative complications: one diaphragm rupture that was repaired during laparoscopy and one bradycardia. Six patients experienced early post-operative complications (<1 month), but there were no grade 3 and 4 complications (3 infections, 1 lymphoedema, 2 hemorrhage). After cytoreductive laparoscopy, the percentage of patients without progression at 12 months was 87.5%.Conclusions Interval ovarian cytoreduction by a laparoscopic approach is safe and feasible for patients with a favorable response to chemotherapy. With the widespread use of neoadjuvant chemotherapy in the management of advanced ovarian cancer, a minimally invasive approach may be a potential option.Data are available upon reasonable request. Data will be provided for the reproducibility of this study in other centers if such is requested. ER -