The INTERNATIONAL MISSION study: minimally invasive surgery in ovarian neoplasms after neoadjuvant chemotherapy.
Adenocarcinoma, Clear Cell
/ drug therapy
Adenocarcinoma, Mucinous
/ drug therapy
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Combined Modality Therapy
Cystadenocarcinoma, Serous
/ drug therapy
Cytoreduction Surgical Procedures
/ mortality
Endometrial Neoplasms
/ drug therapy
Feasibility Studies
Female
Follow-Up Studies
Humans
Middle Aged
Minimally Invasive Surgical Procedures
/ mortality
Neoadjuvant Therapy
/ mortality
Neoplasm, Residual
/ drug therapy
Ovarian Neoplasms
/ drug therapy
Prognosis
Retrospective Studies
Survival Rate
IDS
MIS
NACT
laparoscopy
ovarian cancer
personalized medicine
robotics
Journal
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
ISSN: 1525-1438
Titre abrégé: Int J Gynecol Cancer
Pays: England
ID NLM: 9111626
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
21
07
2018
revised:
23
09
2018
accepted:
25
09
2018
entrez:
15
1
2019
pubmed:
15
1
2019
medline:
7
1
2020
Statut:
ppublish
Résumé
The aim of this retrospective multicenter study was to investigate the extent, feasibility, and outcomes of minimally invasive surgery at the time of interval debulking surgery in different gynecological cancer centers. In December 2016, 20 gynecological cancer centers were contacted by e-mail, to participate in the INTERNATIONAL MISSION study. Seven centers confirmed and five were included, with a total of 127 patients diagnosed with advanced epithelial ovarian cancer after neoadjuvant chemotherapy and minimally invasive interval surgery. Only women with a minimum follow-up time of 6 months from interval surgery or any cancer-related event before 6 months were included in the survival analysis. Baseline characteristics, chemotherapy, and operative data were evaluated. Survival analysis was evaluated using the Kaplan-Meier method. RESULTS : All patients had optimal cytoreduction at the time of interval surgery: among them, 122 (96.1%) patients had no residual tumor. Median operative time was 225 min (range 60 - 600) and median estimated blood loss was 100 mL (range 70 - 1320). Median time to discharge was 2 days (1-33) and estimated median time to start chemotherapy was 20 days (range 15 - 60). Six (4.7%) patients experienced intraoperative complications, with one patient experiencing two serious complications (bowel and bladder injury at the same time). There were six (4.7%) patients with postoperative short-term complications: among them, three patients had severe complications. The conversion rate to laparotomy was 3.9 %. Median follow-up time was 37 months (range 7 - 86): 74 of 127 patients recurred (58.3%) and 31 (24.4%) patients died from disease. Median progression-free survival was 23 months and survival at 5 years was 52 % (95% CI: 35 to 67). Minimally invasive surgery may be considered for the management of patients with advanced ovarian cancer who have undergone neoadjuvant chemotherapy, when surgery is limited to low-complexity standard cytoreductive procedures.
Identifiants
pubmed: 30640676
pii: ijgc-2018-000012
doi: 10.1136/ijgc-2018-000012
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
5-9Informations de copyright
© IGCS and ESGO 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.