Journal of Investigative Surgery (Jun 2022)

Complete Laparoscopic Interval Debulking Surgery for Advanced Ovarian Cancer Achieves Similar Survival Outcomes to Open Approach: A Propensity-Matched Study

  • Lise Lecointre,
  • Madeleine Pellerin,
  • Aïna Venkatasamy,
  • Thibaut Fabacher,
  • Lauriane Eberst,
  • Justine Gantzer,
  • Floriane Jochum,
  • Émilie Faller,
  • Thomas Boisramé,
  • Denis Querleu,
  • Chérif Akladios

DOI
https://doi.org/10.1080/08941939.2022.2045396
Journal volume & issue
Vol. 35, no. 6
pp. 1394 – 1401

Abstract

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Background: To assess the laparoscopic interval debulking surgery (IDS) outcomes compared to laparotomy, by analyzing the overall survival (OS) and the progression free survival (PFS), as well as the intra- and post-operative morbidity. Methods: In this retrospective propensity-score-matched cohort study, all patients with stage III or IV FIGO (International Federation of Gynecology and Obstetrics) serous ovarian cancer, undergoing complete IDS after neoadjuvant chemotherapy, from January 1st of 2009 to June 1st 2019, were included. Results: Thirty-seven patients were included in the laparoscopy group and 40 in the laparotomy group. There was no significant difference in terms of median OS between laparoscopy and laparotomy (23.1 months [95% CI 15.7–29.7] versus 26.3 months [95% CI 21.7–31.7], respectively, p = 0.17) and median PFS (14.8 months [95% CI 10.6–21.5] versus 12 months [95% CI 11–15.1], p = 0.057). After applying the propensity score, 25 patients were included in each group. Laparoscopy was associated with significantly less early postoperative complications (6 versus 17, p = 0.01) and shorter hospital stay (7.6 days versus 12.1, p < 0.001) and a significantly better OS (HR 0.45 [95% CI 0.19–0.95], p = 0.04), but with no significant difference in terms of PFS (HR 0.71 [95% CI 0.27–1.88], p = 0.49). Conclusion: In carefully-selected patients with advanced ovarian cancer, complete laparoscopic interval debulking surgery achieves similar survival outcomes to open laparotomy. Therefore, laparoscopy appears as a safe alternative to laparotomy for IDS after NACT in selected patients with advanced ovarian cancer and a low burden of disease.

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