Impact of Laparoscopy to Assess Resectability in Stage IIIC Epithelial Ovarian, Tubal and Peritoneal Cancer Patients

Gynecol Obstet Invest. 2019;84(3):259-267. doi: 10.1159/000493794. Epub 2018 Nov 14.

Abstract

Aims: To evaluate overall survival (OS) and progression-free survival (PFS) in patients with stage IIIC epithelial ovarian, tubal and peritoneal cancer (EOC) who underwent a laparoscopy to assess surgical resectability prior to Primary Debulking Surgery (PDS) or Interval Debulking Surgery (IDS).

Methods: Retrospective cohort study that included all women with stage IIIC EOC treated at our center between 2000 and 2010. Patients were classified in groups: PDS, neoadjuvant chemotherapy (NACT) with IDS, NACT without IDS; and then sub-classified based on residual tumor (RT). A laparoscopy to assess resectability was performed before PDS and IDS.

Results: Among 111 patients included, 66 underwent PDS, and 45 were treated with NACT, 80% of them receiving subsequent IDS. OS was 75.6 months in the PDS group, and 52.8 months for IDS group (p = 0.100); the PFS was 30 months and 19.2 months respectively (p = 0.049). Median OS was 104.4 and 52.8 months for patients with optimal cytoreduction (RT = 0) in the PDS and IDS group respectively (p < 0.05). Laparoscopy did not modify the preoperative consideration for PDS; however, 9 laparotomies were avoided based on laparoscopic findings after NACT.

Conclusion: Laparoscopy for the assessment of surgical resectability in stage IIIC EOC has no impact on survival; but it still could be useful for the reduction of unnecessary laparotomies after NACT.

Keywords: Disease-free survival; Laparoscopy; Neoplasm staging; Ovarian epithelial cancer; Overall survival.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Ovarian Epithelial / pathology
  • Carcinoma, Ovarian Epithelial / surgery*
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Cytoreduction Surgical Procedures
  • Fallopian Tube Neoplasms / pathology
  • Fallopian Tube Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy*
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Neoplasm, Residual / pathology
  • Neoplasms, Glandular and Epithelial / pathology
  • Ovarian Neoplasms / pathology
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery*
  • Retrospective Studies