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30-10-2023 | Peritonectomy

Laparoscopic versus open approach for interval cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced epithelial ovarian cancer: a matched comparative study

Authors: Manuel Durán-Martínez, Gonzalo Gómez-Dueñas, Lidia Rodriguez-Ortíz, Juan Manuel Sanchez-Hidalgo, Antonio Gordón-Suárez, Ángela Casado-Adam, Sebastián Rufián-Peña, Francisca Valenzuela-Molina, Blanca Rufián-Andujar, María Carmen Vázquez-Borrego, Antonio Romero-Ruiz, Javier Briceño-Delgado, Álvaro Arjona-Sánchez

Published in: Surgical Endoscopy | Issue 1/2024

Abstract

Background

The use of the laparoscopic approach for the treatment of carcinomatosis from epithelial ovarian cancer (EOC) is controversial. The aim of this study was to compare the short-term outcomes of both laparoscopic and open approach for interval CRS+HIPEC in a matched cohort of patients with advanced EOC.

Methods

A retrospective analysis of a prospectively maintained database including 254 patients treated with interval CRS−HIPEC between January 2016 and December 2021 was performed. Patients with primary disease and limited carcinomatosis (PCI ≤ 10) were selected. A comparative analysis of patients treated by either open (O-CRS−HIPEC) or the laparoscopic (L-CRS−HIPEC) approach was conducted. Overall survival (OS), disease-free survival (DFS), and perioperative outcomes were analysed.

Results

Fifty-three patients were finally selected and enrolled into two comparable groups in this study. Of these, 14 patients were treated by interval L-CRS−HIPEC and 39 by interval O-CRS−HIPEC. The L-CRS−HIPEC group had a shorter hospital stay (5.6 ± 1.9 vs. 9.7 ± 9.8 days; p < 0.001) and a shorter time to return to systemic chemotherapy (4.3 ± 1.9 vs. 10.3 ± 16.8 weeks; p = 0.003). There were no significant differences in postoperative complications between both groups. The 2-year OS and DFS was 100% and 62% in the L-CRS−HIPEC group versus 92% and 60% in the O-CRS−HIPEC group, respectively (p = 0.96; p = 0.786).

Conclusion

This study suggests that the use of interval L-CRS−HIPEC for primary advanced EOC is associated with shorter hospital stay and return to systemic treatment while obtaining similar oncological results compared to the open approach. Further prospective research is needed to recommend this new approach for these strictly selected patients.

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Title: Laparoscopic versus open approach for interval cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced epithelial ovarian cancer: a matched comparative study
Authors: Manuel Durán-Martínez
Gonzalo Gómez-Dueñas
Lidia Rodriguez-Ortíz
Juan Manuel Sanchez-Hidalgo
Antonio Gordón-Suárez
Ángela Casado-Adam
Sebastián Rufián-Peña
Francisca Valenzuela-Molina
Blanca Rufián-Andujar
María Carmen Vázquez-Borrego
Antonio Romero-Ruiz
Javier Briceño-Delgado
Álvaro Arjona-Sánchez
Publication date: 30-10-2023
Publisher: Springer US
Keywords: Peritonectomy
Ovarian Cancer
Ovarian Cancer
Peritoneal Cancer
Peritoneal Carcinomatosis
Laparoscopy
Cytostatic Therapy
Published in: Surgical Endoscopy / Issue 1/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10508-w

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Laparoscopic versus open approach for interval cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced epithelial ovarian cancer: a matched comparative study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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