Park Jongmyung, Seike Takashi, Sugi Haruka, Hori Hironobu, Gondo Kanako, Terada Atsumu
Department of Obstetrics and Gynecology, St. Mary's Hospital, Kurume, Fukuoka, Japan.
Gynecol Minim Invasive Ther. 2025 Mar 31;14(2):125-131. doi: 10.4103/gmit.gmit_32_24. eCollection 2025 Apr-Jun.
Despite advancements in the management of advanced ovarian, fallopian tube, and peritoneal cancers, there remains a need to explore safe and effective diagnostic techniques, particularly in cases where primary debulking surgery (PDS) is challenging. This retrospective study aimed to investigate the safety and availability of diagnostic laparoscopy for patients with advanced ovarian, fallopian tube, and peritoneal cancers.
We analyzed data from 36 patients who underwent diagnostic laparoscopy between September 2017 and March 2023. The surgical outcomes of diagnostic laparoscopy and initial treatment outcomes were investigated.
The median patient age was 65 years (range, 39-82 years), with majority diagnosed with high-grade serous carcinoma (HGSC). Perioperative complications were observed in 11% of patients. Neoadjuvant chemotherapy (NAC) was administered to 92% of patients, with PDS performed in two cases. Of the 33 patients who received NAC, 30 (90%) underwent interval debulking surgery, and 23 (77%) achieved complete resection. Two patients (clear-cell carcinoma and mucinous carcinoma) died of cancer before or during the initial chemotherapy. The median follow-up duration for all patients was 26.9 months. Median progression-free survival (PFS) was 19.7 months, and median overall survival was 65.5 months. In multivariate analysis, non-HGSC (hazard ratio: 3.20, 95% confidence interval [CI]: 1.07-9.61, = 0.038) and homologous recombination proficiency (hazard ratio: 7.44, 95% CI: 1.39-39.9, = 0.019) were risk factors for PFS.
Diagnostic laparoscopy is useful for intraperitoneal observation and pretreatment diagnosis in advanced ovarian, fallopian tube, and peritoneal cancers. Despite tolerable perioperative complications, further research is warranted to optimize patient outcomes.
尽管晚期卵巢癌、输卵管癌和腹膜癌的治疗取得了进展，但仍需要探索安全有效的诊断技术，特别是在初次肿瘤细胞减灭术（PDS）具有挑战性的情况下。这项回顾性研究旨在调查诊断性腹腔镜检查对晚期卵巢癌、输卵管癌和腹膜癌患者的安全性和可行性。
我们分析了2017年9月至2023年3月期间接受诊断性腹腔镜检查的36例患者的数据。调查了诊断性腹腔镜检查的手术结果和初始治疗结果。
患者中位年龄为65岁（范围39 - 82岁），大多数患者被诊断为高级别浆液性癌（HGSC）。11%的患者出现围手术期并发症。92%的患者接受了新辅助化疗（NAC），2例患者接受了PDS。在接受NAC的33例患者中，30例（90%）接受了间隔期肿瘤细胞减灭术，23例（77%）实现了完全切除。2例患者（透明细胞癌和黏液性癌）在初始化疗前或化疗期间死于癌症。所有患者的中位随访时间为26.9个月。中位无进展生存期（PFS）为19.7个月，中位总生存期为65.5个月。多因素分析显示，非HGSC（风险比：3.20，95%置信区间[CI]：1.07 - 9.61，P = 0.038）和同源重组熟练（风险比：7.44，95% CI：1.39 - 39.9，P = 0.019）是PFS的危险因素。
诊断性腹腔镜检查对晚期卵巢癌、输卵管癌和腹膜癌的腹腔观察和预处理诊断有用。尽管围手术期并发症可耐受，但仍需要进一步研究以优化患者预后。
