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Debate 12A - Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?

Yes

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Ovarian cancer consistently remains the most lethal gynecologic malignancy because it is predominantly found at an advanced stage. Often, despite efforts to ascertain the potential for successful surgical resection based on imaging, clinical symptomatology, and serum CA-125, it is frequently not determined until the time of surgery with widespread metastasis throughout the peritoneal cavity that was not seen on standard axial imaging. Secondary to the possibility of this “ineffective” or “unnecessary” laparotomy only to discover unresectable cancer, the implementation of diagnostic laparoscopy to determine the extent of the disease and the ability to perform a complete cytoreductive surgery has been adapted by some surgeons. Though data is varied as to the effectiveness of laparoscopy to determine the resectability of advanced ovarian cancer, it adds another layer of diagnostic information through a minimally invasive modality and ultimately prevents patients who are deemed unresectable from going through an invasive, painful procedure that often requires at least a single-day postoperative hospitalization and could delay the initiation of neoadjuvant chemotherapy if there are postoperative complications.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Vrie, Rvan de et al. Laparoscopy for diagnosing resectability of disease in women with advanced ovarian cancer. Cochrane Database Syst Rev 2019;3: CD009786. https://doi.org/10.1002/14651858.CD009786.pub3Google Scholar
Fagotti, A, et al. Role of laparoscopy to assess the chance of optimal cytoreductive surgery in advanced ovarian cancer: a pilot study. Gynecol Oncol 2005;96(3):729735. https://doi.org/10.1016/j.ygyno.2004.11.031Google Scholar
Fagotti, A, et al. Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma. Am J Obstet Gynecol 2008;199(6):642.e1–642.e6. https://doi.org/10.1016/j.ajog.2008.06.052Google Scholar
Fagotti, A, et al. A laparoscopy-based score to predict surgical outcome in patients with advanced ovarian carcinoma: a pilot study. Ann Surg Oncol 2006;13(8):11561161. https://doi.org/10.1245/ASO.2006.08.021CrossRefGoogle ScholarPubMed
Fagotti, A, et al. A multicentric trial (Olympia–MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer. Am J Obstet Gynecol 2013;209(5):462.e1–462.e11. https://doi.org/10.1016/j.ajog.2013.07.016CrossRefGoogle ScholarPubMed
Jansen, FW, et al. Complications of laparoscopy: an inquiry about closed- versus open-entry technique. Am J Obstet Gynecol 2004;190(3):634638. https://doi.org/10.1016/j.ajog.2003.09.035CrossRefGoogle ScholarPubMed

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