Laparoscopy vs. laparotomy for advanced ovarian cancer: a systematic review of the literature

Alletti, Salvatore Gueli; Capozzi, Vito Andrea; Rosati, A.; Blasis, I. De; Cianci, Stefano; Vizzielli, Giuseppe; Uccella, Stefano; Gallotta, Valerio; Fanfani, Francesco; Fagotti, Anna; Scambia, Giovanni

doi:10.23736/s0026-4806.19.06132-9

Cited by 38 publications

(34 citation statements)

References 69 publications

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“…Laparoscopy, a minimally invasive approach for debulking surgery, has been widely applied to treat advanced-stage ovarian cancer ( 39 ). A recent case report successfully demonstrated a step-by-step description of the rectosigmoid mesorectal-sparing resection technique performed on a 54-year-old woman with a diagnosis of FIGO stage 3C advanced ovarian cancer ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

et al. 2022

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BackgroundMalnutrition is often observed in gynecological cancer patients, however its prevalence in these patients remains largely unexplored. Total parenteral nutrition (TPN) is a nutritional intervention method that has controversial treatment outcome on gynecological cancer patients. The present retrospective study is designed to evaluate the nutrition status and TPN treatment outcome on patients diagnosed with endometrial, cervical or ovarian malignant tumors.MethodsMedical records of a total of 263 patients treated at the First Hospital of Shanxi Medical University, China were included. Nutrition status was assessed by patient-generated subjective global assessment (PG-SGA). Patients were grouped based on nutrition status, cancer type or treatment strategy for clinical characteristic comparison. Multivariable logistic regression analysis was used to identify predictors for malnutrition status and hospital stay duration.ResultsPresence of endometrial and cervical cancer, body weight before nutritional intervention and serum albumin level (P < 0.001 for all) were found to be significant predictors for malnutrition status in gynecological cancer patients. In the malnourished patients, those who were treated with TPN had significantly lower serum albumin levels before and after treatment (P < 0.001) and PG-SGA scores after treatment. Also, TPN treatment could significantly increase the serum albumin levels in these patients after 1 week. In addition, shorter hospitalization period was needed for TPN-treated endometrial (P = 0.019) and ovarian (P < 0.001) patients. Moreover, serum albumin levels (P < 0.001), use of TPN treatment (P = 0.025) and nutrition status (P = 0.010) were identified to be independent predictors for hospital stay duration.ConclusionOur results suggest that malnutrition is a significant clinical manifestation in gynecological cancer patients who may benefit from TPN treatment for reduced hospitalization and improved serum albumin levels.

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Section: Discussionmentioning

confidence: 99%

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

et al. 2022

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“…The LANCE (Laparoscopic cytoreduction After Neoadjuvant ChEmotherapy) trial seeks to answer these questions, hypothesizing that for patients who responded to neoadjuvant chemotherapy, minimally invasive interval debulking surgery and laparotomy are equally effective [15]. After all, a systematic re-view by Gueli Alletti et al [16] demonstrated the efficacy and safety of MIS techniques regarding the treatment of advanced ovarian cancer patients and more interestingly the same team suggested that the application of MIS techniques in that very sensitive group of patients plays also a very important role in their psycho-oncologic effect and their quality of life [17]. Furthermore, the INTERNATIONAL MIS-SION study by Fagotti et al [18] as well as a retrospective cohort study by Gallotta et al [19] recently demonstrated that MIS-interval debulking surgery (IDS) can also be an alternative treatment for ovarian cancer patients undergoing secondary cytoreduction following neoadjuvant chemotherapy (NACT).…”

Section: Discussionmentioning

confidence: 99%

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

2021

EJGO

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The purpose of this study is to evaluate the effectiveness and safety of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) approached by minimally invasive surgical (MIS) techniques. We conducted a systematic review of the published relevant studies and evaluated a total of 403 patients, with a median age of 57 years old (20-69). The histology of the patients included 160 (39.7%) patients with pseudomyxoma peritonei, 43 (10.6%) with mesothelioma peritonei, 37 (9.2%) with epithelial ovarian cancer (EOC), 80 (19.8%) with appendiceal cancer and 26 (6.4%) with colon cancer, while the histology of the rest of the patients was not specified in the studies. The median Periotoneal Cancer Index (PCI) was 4 (1-10) and complete cytoreduction (R0) was achieved in 239 patients (60%). 145 (36%) of the patients underwent omentectomy, 37 patients (9.2%) underwent cecum/right colectomy, 41 patients (10.1%) underwent salpingovariectomy, 6 (1.5%) small bowel resection, 28 (6.7%) peritonectomies, in 9 (2.2%) sigmoeidectomy and 107 (26.5%) appendectomy, with a mean operative time of 240 min (90-510). Conversion to laparotomywas performed in 13 (3.2%) cases, while in 32 (7.9%) an intestinal anastomosis or suture was required. The median length of stay was 4.5 days (3-6) and the median follow-up of the patients was 13.5 months (1-72). We concluded that minimal invasive surgery can be considered as an approach in the application of hyperthermic intraperitoneal chemotherapy. Further large studies with higher quality data are warranted to verify our findings.

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“…These include conventional laparoscopy, laparo-endoscopic single-site, robotic multiport, and robotic laparo-endoscopic single-site staging (2)(3)(4)(5). Nowadays, increasing evidence supports the safety of these minimally invasive procedures in ovarian malignancy management (5)(6)(7)(8)(9), suggesting their efficacy even in performing fertilitysparing surgeries or treating advanced stages in carefully selected patients (10,11). The role of minimally invasive surgery in the field of gynecology is continuously evolving thanks to the development of new promising techniques such as robotic and natural orifice transluminal endoscopic surgery (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Surgical Staging of Early-Stage Ovarian Cancers: A Report of Two Cases

2022

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Surgical staging is essential in the management of ovarian cancers. This staging has traditionally been performed by laparotomy, but minimally invasive techniques are increasingly employed. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is a promising technique in the field of gynecological oncology. We report 2 cases of vNOTES surgical staging for suspicious ovarian tumors. We operated on 2 patients aged of 81 and 62 years for low-grade serous ovarian carcinoma and ovarian cystadenofibroma, respectively. We performed surgical staging with a pure vNOTES technique for the first patient and used a hybrid approach for the second. No intraoperative or postoperative complications were observed. We suggest that vNOTES is a feasible and effective approach to surgically manage early-stage ovarian cancers.

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Laparoscopy vs. laparotomy for advanced ovarian cancer: a systematic review of the literature

Cited by 38 publications

References 69 publications

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Surgical Staging of Early-Stage Ovarian Cancers: A Report of Two Cases

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