The Emerging Role of Neutral Argon Plasma (PlasmaJet) in the Treatment of Advanced Stage Ovarian Cancer: A Systematic Review

Abstract

Objective. To evaluate the contribution of PlasmaJet application in achieving optimal cytoreduction in advanced ovarian cancer. Methods. We systematically searched for articles published up to June 2019 using MEDLINE, Scopus, Google Scholar databases and clinicaltrials.gov along with the references of the articles retrieved in full text. Observational studies and case reports addressing cases of women with peritoneal spread due to advanced stage ovarian cancer who were treated with application of PlasmaJet device were considered eligible for inclusion. Results. Three studies were excluded from further analysis when they were retrieved in full text. Five studies (2 retrospective, 1 prospective, and 2 case reports) that comprised 77 patients with age range from 38 to 85 years were included. Forty-three women underwent interval debulking surgery, 24 patients primary debulking surgery, and 6 had optimal debulking surgery, while in the remaining 4, a secondary debulking surgery was performed. Incidence of intraoperative complications was 32% (8/25), but none of them was due to the application of PlasmaJet. Complete macroscopic resection was achieved in 59 out of 70 (84.3%) women. Postoperatively, 17 out of 72 patients (23.6%) developed complications such as pneumothorax due to diaphragmatic resection, systemic infections, or wound-related complications. No postoperative mortality was recorded. Conclusions. Preliminary data on the use of PlasmaJet for ablation of ovarian cancer implants in the peritoneal cavity showed its safety and presented with promising outcomes in achieving complete cytoreduction.

Application of J‑Plasma in the excision of diaphragmatic lesions as part of complete cytoreduction in patients with advanced ovarian cancer

“…Given the fact that OC disseminates through the peritoneum surface, electrosurgical ablative methods and techniques with minimal penetration to the underlying tissue could be beneficial ensuring a lower morbidity as well as eradication of lesions identified in surgically demanding locations (9). Various types of energy sources such as monopolar ablation, CO 2 laser, argon beam plasma and plasma energy, have been proposed aiming at the complete resection of the malignant lesions while simultaneously reducing the lateral spread and penetration to the affected organs (18)(19)(20).…”

Adjuvant Use of PlasmaJet Device During Cytoreductive Surgery for Advanced-Stage Ovarian Cancer: Results of the PlaComOv-study, a Randomized Controlled Trial in The Netherlands

“…The use of neutral argon plasma (Plasma-Jet, Plasma Surgical, Inc, Roswell, GA), in addition to standard surgical instruments may help achieve complete CRS. [10][11][12][13][14][15][16] We performed a study designed to assess whether adjuvant use of PlasmaJet would increase the proportion of complete CRS among patients with advanced-stage EOC. [17][18][19][20]…”

Experience with PlasmaJet™ in debulking surgery in 87 patients with advanced‐stage ovarian cancer

“…To the best of our knowledge, this analysis represents the largest series on the use of PlasmaJet™ in ovarian cancer. Prodromidou et al 27 recently published a systematic review, including five studies, of which there were two case reports. The largest series available was reported by Cordeiro Vidal et al They described their experience with PlasmaJet™ in 51 patients with advanced‐stage ovarian cancer.…”