Single-Institution Propensity-Matched Study to Evaluate the Psychological Effect of Minimally Invasive Interval Debulking Surgery Versus Standard Laparotomic Treatment: From Body to Mind and Back

Alletti, Salvatore Gueli; Vizzielli, Giuseppe; Letizia, Lafuenti; Costantini, Barbara; Fagotti, Anna; Fedele, Camilla; Cianci, Stefano; Perrone, Emanuele; Gallotta, Valerio; Rossitto, Cristiano; Scambia, Giovanni

doi:10.1016/j.jmig.2017.12.007

Cited by 46 publications

(25 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Indeed, it is widely demonstrated that scars on a woman's body may impact body image after surgery. In cancer patients, the connection between physical and mental well-being is strongly linked with progression-free and overall survival [33][34][35]. This aspect suggests particular relevance in our oncological data; in fact, most patients who underwent endometrial cancer surgical staging by PSS reported excellent feedbacks on psychological burden after oncological surgery [10].…”

Section: Discussionmentioning

confidence: 78%

Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Perrone

Rossitto

Fanfani

et al. 2020

Gynecol Obstet Invest

Self Cite

View full text Add to dashboard Cite

Objective: To evaluate the feasibility of percutaneous approach, we prospectively compared our experience in percutaneous-assisted hysterectomy (PSS-H) with that in a series of laparoscopic hysterectomies (LPS-Hs). Methods: In this multicentric cohort study, from May 2015 to October 2017, 160 patients affected by benign and malignant gynecological conditions were considered eligible for minimally invasive surgery (MIS): 80 patients received PSS-H and 80 LPS-H. In each group, 30 cases of low-/intermediate-risk endometrial cancer were enrolled. For both groups, we documented preoperative outcomes, postoperative pain, and cosmetic outcomes. Results: No statistically significant differences were noted in baseline characteristics or operative time. We observed significant differences in estimated blood loss: median of 50 cc (PSS-H) and 100 cc (LPS-H) (p = 0.0001). In LPS-H, we reported 4 (5.0%) intraoperative complications and 1 (1.3%) in PSS-H. Thirty-day complications were 4 (5%) in PSS-H and 11 (13.8%) in LPS-H (p = 0.058). No significative differences were found in visual analog scale score, despite a relevant disparity in cosmetic outcome (p = 0.0001). For oncological cases, the 2 techniques had comparable intraand postoperative outcomes and oncological accuracy. Conclusions: In this study, we reported that PSS-H is comparable to LPS-H for intra-and perioperative outcomes and postoperative pain, while PSS-H seems to be superior in cosmetic outcomes and patient satisfaction. PSS-H may represent a valid alternative in ultra-MIS for benign gynecological conditions and low-/intermediate-risk endometrial cancer.

show abstract

Section: Discussionmentioning

confidence: 78%

Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Perrone

Rossitto

Fanfani

et al. 2020

Gynecol Obstet Invest

Self Cite

View full text Add to dashboard Cite

show abstract

“…PCI is a preferable supplement to our model, which could be improved by including this assessment of the PCI. In addition, several studies reported that minimally invasive interval debulking surgery (MI-IDS) played a positive role in the quality of life and surgery complications ( 27 , 54 ). However, the range of surgical resection in MI-IDS is limited, and a thorough peritoneal evaluation is not possible.…”

Section: Discussionmentioning

confidence: 99%

A Prediction Model for Optimal Primary Debulking Surgery Based on Preoperative Computed Tomography Scans and Clinical Factors in Patients With Advanced Ovarian Cancer: A Multicenter Retrospective Cohort Study

Qin

Jin

et al. 2021

Front. Oncol.

View full text Add to dashboard Cite

ObjectiveThis study assessed the predictive value of preoperative computed tomography (CT) scans and clinical factors for optimal debulking surgery (ODS) in patients with advanced ovarian cancer (AOC).MethodsPatients with AOC in International Federation of Gynecology and Obstetrics (FIGO) stage III-IV who underwent primary debulking surgery (PDS) between 2016 and 2019 from nine tertiary Chinese hospitals were included. Large-volume ascites, diffuse peritoneal thickening, omental cake, retroperitoneal lymph node enlargement (RLNE) below and above the inferior mesenteric artery (IMA), and suspected pelvic bowel, abdominal bowel, liver surface, liver parenchyma and portal, spleen, diaphragm and pleural lesions were evaluated on CT. Preoperative factors included age, platelet count, and albumin and CA125 levels.ResultsOverall, 296 patients were included, and 250 (84.5%) underwent ODS. The prediction model included age >60 years (P=0.016; prediction index value, PIV=1), a CA125 level >800 U/ml (P=0.033, PIV=1), abdominal bowel metastasis (P=0.034, PIV=1), spleen metastasis (P<0.001, PIV=2), diaphragmatic metastasis (P=0.014, PIV=2), and an RLNE above the IMA (P<0.001, PIV=2). This model had superior discrimination (AUC=0.788>0.750), and the Hosmer-Lemeshow test indicated its stable calibration (P=0.600>0.050). With the aim of maximizing the accuracy of prediction and minimizing the rate of inappropriate explorations, a total PIV ≥5 achieved the highest accuracy of 85.47% and identified patients who underwent suboptimal PDS with a specificity of 100%.ConclusionsWe developed a prediction model based on two preoperative clinical factors and four radiological criteria to predict unsatisfactory debulking surgery in patients with AOC. The accuracy of this prediction model needs to be validated and adjusted in further multicenter prospective studies.

show abstract

“…Interval debulking surgery can integrate standard treatment, assess pathological response, and provides an opportunity to remove chemotherapy-resistant clones while improving quality of life in some cases 25. Recently published data have shown an acceptable outcome without interval surgery, suggesting a marginal role in women with good response to chemotherapy 26.…”

Section: Discussionmentioning

confidence: 99%

The INTERNATIONAL MISSION study: minimally invasive surgery in ovarian neoplasms after neoadjuvant chemotherapy

Fagotti

Alletti

Corrado³

et al. 2019

Int J Gynecol Cancer

View full text Add to dashboard Cite

ObjectivesThe aim of this retrospective multicenter study was to investigate the extent, feasibility, and outcomes of minimally invasive surgery at the time of interval debulking surgery in different gynecological cancer centers.Methods/MaterialsIn December 2016, 20 gynecological cancer centers were contacted by e-mail, to participate in the INTERNATIONAL MISSION study. Seven centers confirmed and five were included, with a total of 127 patients diagnosed with advanced epithelial ovarian cancer after neoadjuvant chemotherapy and minimally invasive interval surgery. Only women with a minimum follow-up time of 6 months from interval surgery or any cancer-related event before 6 months were included in the survival analysis. Baseline characteristics, chemotherapy, and operative data were evaluated. Survival analysis was evaluated using the Kaplan–Meier method.Results All patients had optimal cytoreduction at the time of interval surgery: among them, 122 (96.1%) patients had no residual tumor. Median operative time was 225 min (range 60 – 600) and median estimated blood loss was 100 mL (range 70 – 1320). Median time to discharge was 2 days (1–33) and estimated median time to start chemotherapy was 20 days (range 15 – 60). Six (4.7%) patients experienced intraoperative complications, with one patient experiencing two serious complications (bowel and bladder injury at the same time). There were six (4.7%) patients with postoperative short-term complications: among them, three patients had severe complications. The conversion rate to laparotomy was 3.9 %. Median follow-up time was 37 months (range 7 – 86): 74 of 127 patients recurred (58.3%) and 31 (24.4%) patients died from disease. Median progression-free survival was 23 months and survival at 5 years was 52 % (95% CI: 35 to 67).ConclusionsMinimally invasive surgery may be considered for the management of patients with advanced ovarian cancer who have undergone neoadjuvant chemotherapy, when surgery is limited to low-complexity standard cytoreductive procedures.

show abstract

Single-Institution Propensity-Matched Study to Evaluate the Psychological Effect of Minimally Invasive Interval Debulking Surgery Versus Standard Laparotomic Treatment: From Body to Mind and Back

Cited by 46 publications

References 27 publications

Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

Percutaneous-Assisted versus Laparoscopic Hysterectomy: A Prospective Comparison

A Prediction Model for Optimal Primary Debulking Surgery Based on Preoperative Computed Tomography Scans and Clinical Factors in Patients With Advanced Ovarian Cancer: A Multicenter Retrospective Cohort Study

The INTERNATIONAL MISSION study: minimally invasive surgery in ovarian neoplasms after neoadjuvant chemotherapy

Contact Info

Product

Resources

About