Robotic interval debulking surgery for advanced epithelial ovarian cancer: current challenge or future direction? A systematic review.
Blood Loss, Surgical
/ statistics & numerical data
Carcinoma, Ovarian Epithelial
/ drug therapy
Cytoreduction Surgical Procedures
/ methods
Female
Follow-Up Studies
Humans
Laparotomy
Length of Stay
Neoadjuvant Therapy
Neoplasm Recurrence, Local
/ epidemiology
Operative Time
Ovarian Neoplasms
/ drug therapy
Postoperative Complications
/ epidemiology
Robotic Surgical Procedures
/ methods
Survival Rate
Treatment Outcome
Interval debulking surgery
Ovarian cancer
Robotic surgery
Journal
Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
15
07
2020
accepted:
30
09
2020
pubmed:
11
10
2020
medline:
14
9
2021
entrez:
10
10
2020
Statut:
ppublish
Résumé
We evaluated the effectiveness, safety and efficacy of robotic interval debulking surgery (IDS) in advanced epithelial ovarian cancer (EOC) treated with neoadjuvant chemotherapy (NACT). We conducted a systematic review of the published relevant studies. Α total of 102 patients were evaluated. Mean operative time ranged from 164 to 312 min (mean ± SD: 246 ± 61 min) while mean estimated blood loss ranged from 106.9 to 262.5 ml (mean ± SD: 168 ± 68 ml) and postoperative blood transfusion rate was 19% (n = 19/98). Complete cytoreduction rate (R0 resection) was achieved in 75 patients (76.5%), whereas residual disease ≤ 1 cm in 21 women (21.5%). Mean hospital stay was 2.4 days. No intraoperative and six postoperative (14.6%) complications were reported. Laparotomy conversion rate was 9.2% (9/98) mostly in the terms of achieving complete cytoreduction and 30-day mortality rate was 9.2% (n = 9/98). The median overall survival varied from 39.7 to 47.2 months, while the progression-free survival ranged from 20.6 to 21.2 months during a median follow-up period from 2 to 86 months (median 25.3 months). A total of 60 women (61%) developed disease recurrence. One of the studies reported significantly improved OS and PFS in patients who underwent robotic IDS when compared to those who had laparotomy either during or before the addition of robotic surgery in the management of advanced ovarian cancer disease (47.2 vs 37.8 vs 37.9, p = 0.004 for OS and 20.6 vs 13.9 vs 11.9, p = 0.005 for PFS, respectively). The same was also observed when controlling the parameters of age and stage for patients in the robotic arm (p = 0.02). Robotic interval debulking surgery can be considered in the management of advanced ovarian cancer patients after receiving neoadjuvant chemotherapy. Larger meta-analyses including multicenter randomized control trials are necessary to specify the exact profile of the patients that could benefit from this treatment strategy.
Identifiants
pubmed: 33037532
doi: 10.1007/s11701-020-01155-7
pii: 10.1007/s11701-020-01155-7
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
155-163Références
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