Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy.
J Minim Invasive Gynecol. 2018 May-Jun;25(4):644-650. doi: 10.1016/j.jmig.2017.10.024. Epub 2017 Nov 13.
To analyze the feasibility and safety of laparoscopic secondary cytoreductive surgery in a retrospective series of patients with platinum-sensitive recurrent ovarian cancer.
Retrospective cohort study (Canadian Task Force classification II-2).
Catholic University of the Sacred Heart, Rome, Italy.
Between October 2010 and October 2016, 58 patients with recurrent ovarian cancer were selected for a retrospective analysis of data.
All patients underwent a laparoscopic secondary cytoreduction with single or multiple procedures.
The most frequent pattern of recurrence was peritoneal (48.3%); 6 patients (10.3%) experienced parenchymal disease (spleen, n = 5; liver, n = 1), and 24 patients (41.4%) had lymph node recurrence. Complete debulking was achieved in all patients. The median operative time was 204 minutes (range, 55-448 minutes), median estimated blood loss was 70 mL (range, 20-300 mL), and the median length of hospital stay was 4 days (range, 1-21 days). Four patients (6.8%) experienced intraoperative complications. Early postoperative complications were documented in 6 patients (10.3%), but only 1 G3 complication was noted. The median duration of follow-up since secondary cytoreduction was 24 months (range, 9-71 months). Twenty-one patients (36.2%) experienced a second disease relapse. The median progression-free survival (PFS) was 28 months, and the 2-year PFS was 58.7%. Five patients died (8.6%); the 2-year overall survival was 90.7%.
For selected patients, laparoscopy is a feasible and safe approach to optimal cytoreduction for patients with recurrent ovarian cancer.
分析在一组铂类敏感复发性卵巢癌患者的回顾性系列中，腹腔镜下二次细胞减灭术的可行性和安全性。
回顾性队列研究（加拿大任务组分类 II-2）。
意大利罗马天主教圣心大学。
2010 年 10 月至 2016 年 10 月期间，选择了 58 例复发性卵巢癌患者进行数据回顾性分析。
所有患者均行腹腔镜下二次细胞减灭术，采用单次或多次手术。
最常见的复发模式是腹膜（48.3%）；6 例（10.3%）患者发生实质疾病（脾 5 例，肝 1 例），24 例（41.4%）患者发生淋巴结复发。所有患者均达到完全减瘤。中位手术时间为 204 分钟（范围 55-448 分钟），中位估计出血量为 70 毫升（范围 20-300 毫升），中位住院时间为 4 天（范围 1-21 天）。4 例（6.8%）患者发生术中并发症。6 例（10.3%）患者发生早期术后并发症，但仅 1 例为 G3 并发症。自二次细胞减灭术后中位随访时间为 24 个月（范围 9-71 个月）。21 例（36.2%）患者发生二次疾病复发。中位无进展生存期（PFS）为 28 个月，2 年 PFS 为 58.7%。5 例患者死亡（8.6%）；2 年总生存率为 90.7%。
对于选定的患者，腹腔镜是铂类敏感复发性卵巢癌患者进行最佳细胞减灭术的可行且安全的方法。
