Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series

Valerio Gallotta, Fabio Ghezzi, Enrico Vizza, Anna Fagotti, Marcello Ceccaroni, Francesco Fanfani, Vito Chiantera, Alfredo Ercoli, Cristiano Rossitto, C. Conte, Stefano Uccella, Giacomo Corrado, Giovanni Scambia, Gabriella Ferrandina

Research output: Contribution to journalArticle

Abstract

Study Objective: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Multi-institutional study performed in 6 referral gynecologic oncology units. Patients: Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach. Interventions: All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction. Measurements and results: Sixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6-55 months); 15 (21.7%) patients developed recurrence. Conclusion: The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.

Original languageEnglish
Pages (from-to)590-596
Number of pages7
JournalJournal of Minimally Invasive Gynecology
Volume23
Issue number4
DOIs
Publication statusPublished - May 1 2016

Fingerprint

Ovarian Neoplasms
Lymph Nodes
Neoplasm Metastasis
Carcinoma
Lymph Node Excision
Pelvis
Disease-Free Survival
Survival Rate
Recurrence
Advisory Committees
Cohort Studies
Referral and Consultation
Retrospective Studies
Safety

Keywords

  • Laparoscopic cytoreduction
  • Laparoscopy
  • Minimally invasive surgery
  • Ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases : Results of a Retrospective Multi-institutional Series. / Gallotta, Valerio; Ghezzi, Fabio; Vizza, Enrico; Fagotti, Anna; Ceccaroni, Marcello; Fanfani, Francesco; Chiantera, Vito; Ercoli, Alfredo; Rossitto, Cristiano; Conte, C.; Uccella, Stefano; Corrado, Giacomo; Scambia, Giovanni; Ferrandina, Gabriella.

In: Journal of Minimally Invasive Gynecology, Vol. 23, No. 4, 01.05.2016, p. 590-596.

Research output: Contribution to journalArticle

Gallotta, V, Ghezzi, F, Vizza, E, Fagotti, A, Ceccaroni, M, Fanfani, F, Chiantera, V, Ercoli, A, Rossitto, C, Conte, C, Uccella, S, Corrado, G, Scambia, G & Ferrandina, G 2016, 'Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series', Journal of Minimally Invasive Gynecology, vol. 23, no. 4, pp. 590-596. https://doi.org/10.1016/j.jmig.2016.01.029
Gallotta, Valerio ; Ghezzi, Fabio ; Vizza, Enrico ; Fagotti, Anna ; Ceccaroni, Marcello ; Fanfani, Francesco ; Chiantera, Vito ; Ercoli, Alfredo ; Rossitto, Cristiano ; Conte, C. ; Uccella, Stefano ; Corrado, Giacomo ; Scambia, Giovanni ; Ferrandina, Gabriella. / Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases : Results of a Retrospective Multi-institutional Series. In: Journal of Minimally Invasive Gynecology. 2016 ; Vol. 23, No. 4. pp. 590-596.
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title = "Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series",
abstract = "Study Objective: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Multi-institutional study performed in 6 referral gynecologic oncology units. Patients: Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach. Interventions: All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction. Measurements and results: Sixty-nine patients were included in the analysis. Twenty-eight (40.6{\%}) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4{\%} of cases, whereas aortic lymphadenectomy was performed in 79.7{\%} of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4{\%}) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1{\%}, whereas the 2-year overall survival rate was 90.6{\%}. The median time to recurrence was 26 months (range, 6-55 months); 15 (21.7{\%}) patients developed recurrence. Conclusion: The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.",
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AU - Vizza, Enrico

AU - Fagotti, Anna

AU - Ceccaroni, Marcello

AU - Fanfani, Francesco

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N2 - Study Objective: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement. Design: Retrospective cohort study (Canadian Task Force classification II-2). Setting: Multi-institutional study performed in 6 referral gynecologic oncology units. Patients: Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach. Interventions: All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction. Measurements and results: Sixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6-55 months); 15 (21.7%) patients developed recurrence. Conclusion: The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.

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