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Abstract
Objective: To evaluate the feasibility and the effect of the laparoscopic debulking surgery in the treatment of advanced ovarian cancer after neoadjuvant chemotherapy.
Methods: We performed a retrospective review of laparoscopic approach in patients with histologically confirmed epithelial ovarian cancer (International Federation of Gynaecology Obstetrics stages IIIC-IV) who received 3 courses of neoadjuvant chemo-therapy, from January 2012 to January 2017, at the Department of Obstetrics and Gynaecology, Hue Central Hospital.
Results: A total of 30 patients were included. The median age was 50 years (range, 26-73 years), median body mass index was 24.5 kg/m 2 (range, 19-39 kg/m2 ). All patients had good clinical response to 3 cycles of neoadjuvant chemotherapy. Most women underwent a complete debulking surgery with no residual disease (56.6%). The median operating time was 152 minutes (range, 70-335 minutes), the median blood loss was 70 mL (range, 50-200 mL). The median number of removed pelvic lymph nodes was 15 (range, 13-25). There was 1 (3.3%) intraoperative complication and 2 (6.6%) postoperative short-term complications. The median length of hospital stay was 4 days (range, 3-13 days). The median follow-up was 15 months (range, 2-54 months). Twenty-six patients are free from recurrence at this time.
Conclusions: Laparoscopic cytoreduction when performed by skilled surgeons, seems feasible and may decrease the impact of aggressive surgery in patients with advanced ovarian cancer after neoadjuvant chemotherapy, is an attractive alternative to the traditional abdominal surgical approach. The significant advantages of this approach are less invasive surgery, less blood loss during surgery, short recovery time.
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