Objective: To assess the feasibility and outcomes of laparoscopic cytoreduction in selected patients with localized recurrent epithelial ovarian cancer (EOC) and to perform survival analysis and compare it with that of laparotomy.
Patients and Methods: We performed a retrospective analysis of 125 EOC patients who had localized recurrent sites, as demonstrated by CT scan, MRI, or PET/CT scan; no ascites; had been disease-free for 12 or more months; and who had undergone secondary or tertiary cytoreduction (laparoscopy in 38, laparotomy in 87) at Samsung Medical Center between 2002 and 2013. By reviewing the electric medical records, we investigated patient baseline characteristics, surgical characteristics, and surgical outcomes.
Results: There were no statistically significant differences between the two groups of patients in terms of age, BMI, tumor type, initial stage, grade, recurrence site, types of adjuvant chemotherapy, or disease-free interval from previous treatment. With regard to surgical outcome, the laparoscopic approach provided similar or beneficial outcomes compared to laparotomy. Reduced operating time, decreased EBL, and shorter hospital stay were achieved in the laparoscopic group. Survival analysis showed better PFS after cytoreduction in the laparoscopy group. Significant prognostic factors in multivariate analysis were initial tumor grade for PFS and complete debulking for OS in these patients.
Conclusion: Although the present study is limited by its retrospective design and selection bias, the laparoscopic approach is feasible without compromising morbidity and survival in selected groups of patients with recurrent EOC. Reduced operating time, decreased EBL, and shorter hospital stay were achieved in the laparoscopic group. The laparoscopic method provides similar or beneficial outcomes in these patients compared to laparotomy.