Ackroyd Sarah A, Thomas Sajeena, Angel Cynthia, Moore Richard, Meacham Philip J, DuBeshter Brent
School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA, USA.
J Robot Surg. 2018 Jun;12(2):245-250. doi: 10.1007/s11701-017-0720-2. Epub 2017 Jun 19.
The objective of this study is to review our experience with robotic interval cytoreduction following neoadjuvant chemotherapy for advanced ovarian cancer. We retrospectively reviewed patients with advanced ovarian cancer treated with neoadjuvant chemotherapy (NAC) and interval robotic cytoreduction (IRC) between 2011 and 2016 at the University of Rochester Medical Center. Demographic information, chemotherapy treatment, operative results, and follow-up were extracted from medical records. Twenty-nine patients underwent IRC after a mean of 3.9 cycles of NAC. The mean operative time was 165 min with a mean EBL of 107 cc. The mean length of stay was 2.0 days. One case (3.3%) was converted to an open procedure because of extensive tumor not amenable to robotic cytoreduction. Overall, 19 (66%) patients underwent an R0 cytoreduction, 8 (28%) an optimal (<1 cm) cytoreduction, and 2 (7%) a suboptimal cytoreduction. The median overall survival was 39.7 months and median progression-free survival was 21.2 months. Interval robotic cytoreduction following NAC is feasible and may be preferable to open interval cytoreductive surgery, in specific patients, to minimize morbidity and length of hospital stay.
本研究的目的是回顾我们对晚期卵巢癌新辅助化疗后进行机器人间歇性肿瘤细胞减灭术的经验。我们回顾性分析了2011年至2016年在罗切斯特大学医学中心接受新辅助化疗（NAC）和间歇性机器人肿瘤细胞减灭术（IRC）治疗的晚期卵巢癌患者。从病历中提取人口统计学信息、化疗治疗情况、手术结果和随访信息。29例患者在平均接受3.9个周期的NAC后接受了IRC。平均手术时间为165分钟，平均估计失血量为107毫升。平均住院时间为2.0天。1例（3.3%）因肿瘤广泛无法进行机器人肿瘤细胞减灭术而转为开放手术。总体而言，19例（66%）患者实现了R0肿瘤细胞减灭，8例（28%）实现了最佳（<1厘米）肿瘤细胞减灭，2例（7%）实现了次优肿瘤细胞减灭。中位总生存期为39.7个月，中位无进展生存期为21.2个月。对于特定患者，NAC后进行机器人间歇性肿瘤细胞减灭术是可行的，并且可能比开放性间歇性肿瘤细胞减灭术更可取，以尽量减少发病率和住院时间。
