Skip to main content
Log in

Laparoscopic surgical management of localized recurrent ovarian cancer: a single-institution experience

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Optimally, secondary cytoreduction is acknowledged as a valid option in terms of oncologic outcome for patients with platinum-sensitive recurrent ovarian cancer. In cases of localized relapse, a laparoscopic approach has been attempted at various institutions, but studies on its role for this subset of patients still are limited. This report describes the authors’ experience using laparoscopic secondary cytoreduction for patients with localized recurrent ovarian cancer. The results from a retrospective analysis of a prospective case series are reported.

Methods

Between October 2011 and May 2013, 29 patients with localized recurrent ovarian cancer were selected for a laparoscopic cytoreduction. Two conversions to laparotomy occurred. The analyzed outcome variables included stage and site of disease, type of surgical procedure, operative time, blood loss, length of hospital stay, complications, and oncologic outcome.

Results

The median operating time was 188 min. The median estimated blood loss was 150 mL, and the median hospital stay was 4 days. Complete debulking was achieved for 96.2 % of the patients. No intraoperative complications occurred, and postoperative complications were noted in only one patient. The median disease-free survival time was 14 months.

Conclusions

For selected patients, laparoscopy is a feasible and safe approach to optimal cytoreduction for patients with localized recurrent ovarian cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Park JY, Kim DY, Kim JH, Kim YM, Kim YT, Nam JH (2012) Laparoscopic versus open radical hysterectomy for elderly patients with early-stage cervical cancer. Am J Obstet Gynecol 207:195.e1–195.e8

    Google Scholar 

  2. Hong JH, Choi JS, Lee JH, Eom JM, Ko JH, Bae JW, Park SH (2012) Can laparoscopic radical hysterectomy be a standard surgical modality in stage IA2-IIA cervical cancer? Gynecol Oncol 127:102–106

    Article  PubMed  Google Scholar 

  3. Galaal K, Bryant A, Fisher AD, Al-Khaduri M, Kew F, Lopes AD (2012) Laparoscopy versus laparotomy for the management of early stage endometrial cancer (review). Cochrane Database Syst Rev 9:CD006655

    PubMed  Google Scholar 

  4. Park HJ, Kim DW, Yim GW, Nam EJ, Kim S, Kim YT (2013) Staging laparoscopy for the management of early-stage ovarian cancer: a metaanalysis. Am J Obstet Gynecol 58:e1–e8. doi:10.1016/S0002-9378(13)00362-1

    Article  Google Scholar 

  5. Ghezzi F, Malzoni M, Vizza E, Cromi A, Perone C, Corrado G, Uccella S, Cosentino F, Mancini E, Franchi M (2012) Laparoscopic staging of early ovarian cancer: results of a multiinstitutional cohort study. Ann Surg Oncol 19:1589–1594

    Article  PubMed  Google Scholar 

  6. Fagotti A, Fanfani F, Vizzielli G, Gallotta V, Ercoli A, Paglia A, Costantini B, Vigliotta M, Scambia G, Ferrandina G (2012) Should laparoscopy be included in the workup of advanced ovarian cancer patients attempting interval debulking surgery? Gynecol Oncol 116:72–77

    Article  Google Scholar 

  7. Fagotti A, Ferrandina G, Fanfani F, Garganese G, Vizzielli G, Carone V, Salerno MG, Scambia G (2012) Prospective validation of a laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma. Am J Obstet Gynecol 199:642.e1–642.e6

    Google Scholar 

  8. Fagotti A, Fanfani F, Rossitto C, Lorusso D, De Gaetano AM, Giordano A, Vizzielli G, Scambia G (2008) A treatment selection protocol for recurrent ovarian cancer patients: the role of FDG-PET/CT and staging laparoscopy. Oncology 75:152–158

    Article  CAS  PubMed  Google Scholar 

  9. Al Rawahi T, Lopes AD, Bristow RE, Bryant A, Elattar A, Chattopadhyay S, Galaal K (2013) Surgical cytoreduction for recurrent epithelial ovarian cancer (review). Cochrane Database Syst Rev 2:CD008765

    PubMed  Google Scholar 

  10. Bristow RE, Puri I, Chi DS (2009) Cytoreductive surgery for recurrent ovarian cancer: a meta-analysis. Gynecol Oncol 112:265–274

    Article  PubMed  Google Scholar 

  11. Petrillo M, Fagotti A, Ferrandina G, Fanfani F, Costantini B, Vizzielli G, Pedone Anchora L, Nero C, Margariti PA, Scambia G (2013) Ovarian cancer patients with localized relapse: clinical outcome and prognostic factors. Gynecol Oncol 131:36–41

    Article  CAS  PubMed  Google Scholar 

  12. Harter P, Sehouli J, Reuss A, Hasenburg A, Scambia G, Cibula D, Mahner S, Vergote I, Reinthaller A, Burges A, Hanker L, Pölcher M, Kurzeder C, Canzler U, Petry KU, Obermair A, Petru E, Schmalfeldt B, Lorusso D, du Bois A (2011) Prospective validation study of a predictive score for operability of recurrent ovarian cancer: the Multicenter Intergroup Study DESKTOP II. A project of the AGO Kommission OVAR, AGO Study Group, NOGGO, AGO-Austria, and MITO. Int J Gynecol Cancer 21:289–295

    Article  PubMed  Google Scholar 

  13. Trinh H, Ott C, Fanning J (2004) Feasibility of laparoscopic debulking with electrosurgical loop excision procedure and argon beam coagulator at recurrence in patients with previous laparotomy debulking. Am J Obstet Gynecol 190:1394–1397

    Article  PubMed  Google Scholar 

  14. Nezhat FR, Denoble SM, Cho JE, Brown DN, Soto E, Chuang L, Gretz H, Saharia P (2012) Safety and efficacy of video laparoscopic surgical debulking of recurrent ovarian, fallopian tube, and primary peritoneal cancers. JSLS 16:511–518

    Article  PubMed Central  PubMed  Google Scholar 

  15. Magrina JF, Cetta RL, Chang YH, Guevara G, Magtibay PM (2013) Analysis of secondary cytoreduction for recurrent ovarian cancer by robotics, laparoscopy, and laparotomy. Gynecol Oncol 129:336–340

    Article  PubMed  Google Scholar 

  16. Chassagne D, Sismondi P, Horiot JC, Sinistrero G, Bey P, Zola P, Pernot M, Gerbaulet A, Kunkler I, Michel G (1993) A glossary for reporting complications of treatment in gynecological cancers. Radiother Oncol 26:195–202

    Article  CAS  PubMed  Google Scholar 

  17. Kisu I, Banno K, Tsuji K, Masuda K, Ueki A, Kobayashi Y, Yamagami W, Susumu N, Aoki D (2012) Narrow-band imaging in gynecology: a new diagnostic approach with improved visual identification (review). Int J Oncol 40:350–356

    PubMed  Google Scholar 

  18. Gagliardi ML, Polito S, Fagotti A, Fanfani F, Scambia G (2013) Narrow-band imaging in laparoscopic management of recurrent platinum sensitive ovarian cancer. J Minim Invasive Gynecol 20:10–12

    Article  PubMed  Google Scholar 

  19. Fanfani F, Gallotta V, Rossitto C, Fagotti A, Scambia G (2010) Narrow-band imaging in borderline ovarian tumor. J Minim Invasive Gynecol 17:146–147

    Article  CAS  PubMed  Google Scholar 

  20. Fanfani F, Rossitto C, Fagotti A, Gallotta V, Gagliardi ML, Scambia G (2011) Narrow-band imaging in laparoscopic management of cervical carcinoma. J Minim Invasive Gynecol 18:146–147

    Article  PubMed  Google Scholar 

Download references

Disclosures

Valerio Gallotta, Anna Fagotti, Francesco Fanfani, Gabriella Ferrandina, Camilla Nero, Barbara Costantini, Salvatore Gueli Alletti, Vito Chiantera, Alfredo Ercoli, and Giovanni Scambia have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Camilla Nero.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gallotta, V., Fagotti, A., Fanfani, F. et al. Laparoscopic surgical management of localized recurrent ovarian cancer: a single-institution experience . Surg Endosc 28, 1808–1815 (2014). https://doi.org/10.1007/s00464-013-3390-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-013-3390-9

Keywords

Navigation