Should laparoscopy be included in the work-up of advanced ovarian cancer patients attempting interval debulking surgery?

A. Fagotti, F. Fanfani, G. Vizzielli, V. Gallotta, A. Ercoli, A. Paglia, B. Costantini, M. Vigliotta, G. Scambia, G. Ferrandina

Research output: Contribution to journalArticle

Abstract

Objectives: Primary: To investigate whether S-LPS could contribute to a better identification of patients to submit to IDS. Secondary: To identify the most appropriate level of laparoscopic index value (PIV) to identify inoperable patients in this subset of patients. Methods: A prospective single-institutional study including patients with advanced ovarian/peritoneal cancer (FIGO stage IIIC-IV) to be submitted to IDS after NACT. Patients have been considered eligible for surgical exploration in case of complete/partial radiological or serological response; stable disease if primary surgery had been performed in a different hospital; progressive radiological disease in the presence of serological response, young age, and good performance status (ECOG <1); and progressive serological disease with stable clinical and radiological disease. A laparoscopic assessment for each patient has been performed. Results: Ninety-eight consecutive AOC patients submitted to NACT have been eligible for the study. With the addition of S-LPS to the RECIST criteria, a surgical exploration is performed in all patients and the percentage of explorative laparotomies drops to about 10%. The use of S-LPS after the GCIG criteria can reduce the risk of both explorative laparotomies from 30% to 13%, and inappropriate unexplorations from 18% to 0%. Moreover, at a PIV > 4 the probability of optimally resecting the disease at laparotomy is equal to 0. Conclusions: Present data suggest that S-LPS can play a relevant role to discriminate patients with partially/stable disease or referred from other Institutions after NACT, which can be susceptible of successful IDS.

Original languageEnglish
Pages (from-to)72-77
Number of pages6
JournalGynecologic Oncology
Volume116
Issue number1
DOIs
Publication statusPublished - Jan 2010

Keywords

  • Interval debulking surgery
  • Laparoscopy
  • Neo-adjuvant chemotherapy
  • Ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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    Fagotti, A., Fanfani, F., Vizzielli, G., Gallotta, V., Ercoli, A., Paglia, A., Costantini, B., Vigliotta, M., Scambia, G., & Ferrandina, G. (2010). Should laparoscopy be included in the work-up of advanced ovarian cancer patients attempting interval debulking surgery? Gynecologic Oncology, 116(1), 72-77. https://doi.org/10.1016/j.ygyno.2009.09.015