Incorporating laparoscopic interval cytoreductive surgery for advanced ovarian cancer-lessons learnt

Abstract

Objective: To assess the utility of laparoscopy for interval cytoreductive surgery (CRS) in patients with advanced ovarian cancer after Neo-Adjuvant Chemotherapy (NACT). Methods: A retrospective cohort study of interval CRS by laparoscopy in patients with advanced epithelial ovarian cancer treated at a single tertiary gynaecological cancer centre between October 2017 and September 2020. Results: 86 patients had interval CRS by the laparoscopic route during the study period. The optimal cytoreduction rate (R ​< ​1 ​cm) was 92%, and complete cytoreduction rate with no residual disease (R ​= ​0) was 35%. The intra-operative complication rate was 8% and the estimated blood loss (EBL) was 90 ​ml. The post-operative complication rate was 15%, mostly grade I-II, and the median length of hospital stay was 3 days. Conclusion: For most patients with advanced ovarian cancer after NACT, laparoscopic interval CRS is feasible and effective in achieving optimal cytoreduction while providing a favourable peri-operative outcome. In some cases, however, recourse to laparotomy will optimise complete macroscopic resection.