SHORT TERM OUTCOMES OF LAPAROSCOPIC INTERVAL DEBULKING SURGERY POST
NEOADJUVANT CHEMOTHERAPY IN ADVANCED OVARIAN CARCINOMA
Abstract
OBJECTIVE: The objective of this study is to establish the feasibility
of the Laparoscopic debulking surgery in post neoadjuvant chemotherapy
advanced ovarian cancer. METHODS / MATERIALS: 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 chemotherapy, from January 2015 to December 2017,
at the Gynecologic Oncologic Unit, Galaxy care hospital and research
centre, Pune, Maharashtra, India. Results: A total of 30 patients were
included. The median age was 48.3 years (range, 26-63 years), median
body mass index was 24.5 kg/m2 (range, 19-39 kg/m2). All patients had a
good clinical response to 3 cycles of neoadjuvant chemotherapy. All
women underwent a complete debulking surgery with no residual disease.
The median operating time was 152 minutes (range, 70-335 minutes), the
median blood loss was 70 mL (range, 50-130 mL). The median number of
removed pelvic lymph nodes was 17 (range, 13-25). The median length of
hospital stay was 4.6 days (range, 2-15 days). The median follow-up was
15 months (range, 2-54 months). Twenty patients are free from recurrence
at the time of this report. The most common site of recurrence was the
local (five out of 30). All patients received chemotherapy
postoperatively on median post-op day 9 (range, 7-14) Conclusions:
Laparoscopic cytoreduction in patients with advanced ovarian cancer
after neoadjuvant chemotherapy, when performed by skilled surgeons,
seems feasible and may decrease the impact of aggressive surgery on
high-morbidity patients after chemotherapy.