Liang Huamao, Guo Hongyan, Zhang Chunyu, Zhu FuLi, Wu Yu, Zhang Kun, Li Hua, Han Jinsong
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, P.R. China.
Oncotarget. 2017 Nov 3;8(68):113239-113247. doi: 10.18632/oncotarget.22573. eCollection 2017 Dec 22.
To assess the feasibility and outcome of primary laparoscopic cytoreductive surgery on advanced epithelial ovarian cancer in comparison with conventional open surgery.
Patients undergoing primary laparoscopic cytoreductive surgery (LCS) from March 2007 to December 2016 were matched to controls treated with laparotomic cytoreduction during the same period. Procedural data and outcomes were analyzed.
The LCS group ( = 64) and laparotomic group ( = 68) had similar age, BMI, stages, histologic type and grading. The LCS group exhibited significantly less operating time ( < 0.001), less intraoperative blood loss ( < 0.001), and shorter time to recover postoperatively ( = 0.002). No statistical difference was observed for the number of pelvic and para-aortic lymph nodes dissected ( = 0.326 and = 0.151). Significant difference was observed in satisfaction of the cytoreduction (95.3% vs. 76.5%, = 0.008). No significant difference were observed either in intra-operative or in post-operative complications between the two groups ( = 0.250). Three patients in the LCS group experienced intra-operative complications (4.7%) and were all treated laparoscopically. The conversion rate was 3.1%. No significant differences were observed in the progression-free survival and overall survival between the two groups during the medium follow-up of 18 months ( = 0.236 and = 0.216). The 2-year and 3-year progression-free survival was 67.9%, 55.5% in LCS group and 53.8%, 33.3% respectively in the control group. The 2-year and 3-year overall survival was 95.8%, 88.7% respectively in the LCS group and 89.0%, 83.7% in the control group.
Primary laparoscopic cytoreductive surgery in some strictly selected advanced stages of EOC patients was feasible and safe, resulting in oncologic outcomes not inferior to those in open surgery.
比较原发性腹腔镜减瘤手术与传统开放手术治疗晚期上皮性卵巢癌的可行性及疗效。
将2007年3月至2016年12月接受原发性腹腔镜减瘤手术（LCS）的患者与同期接受开腹减瘤手术的对照组患者进行匹配。分析手术数据及疗效。
LCS组（n = 64）和开腹手术组（n = 68）在年龄、BMI、分期、组织学类型及分级方面相似。LCS组手术时间明显更短（P < 0.001），术中出血量更少（P < 0.001），术后恢复时间更短（P = 0.002）。两组清扫的盆腔及腹主动脉旁淋巴结数量无统计学差异（P = 0.326和P = 0.151）。减瘤满意度存在显著差异（95.3% 对76.5%，P = 0.008）。两组术中及术后并发症无显著差异（P = 0.250）。LCS组3例患者发生术中并发症（4.7%），均通过腹腔镜治疗。中转开腹率为3.1%。在18个月的中期随访中，两组的无进展生存期和总生存期无显著差异（P = 0.236和P = 0.216）。LCS组2年和3年无进展生存率分别为67.9%、55.5%，对照组分别为53.8%、33.3%。LCS组2年和3年总生存率分别为95.8%、88.7%，对照组分别为89.0%、83.7%。
在一些严格筛选的晚期上皮性卵巢癌患者中，原发性腹腔镜减瘤手术可行且安全，肿瘤学疗效不低于开放手术。
