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A Systematic Review of Robotic Interval Debulking Surgery for Advanced Epithelial Ovarian Cancer

2020 Year in Review - Ovarian Cancer - Ovarian Cancer

Robotic interval debulking surgery is efficient and safe when treating patients with advanced ovarian cancer who are receiving neoadjuvant chemotherapy.

Using a systematic literature review, Victoria Psomiadou and colleagues evaluated the efficacy and safety of robotic interval debulking surgery after treatment with neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. They presented their findings at the European Society of Gynaecological Oncology 2020 Virtual Conference.

In total, 102 patients were evaluated. Estimated perioperative outcomes were mean operative time ranging from 164 minutes to 312 minutes, mean estimated blood loss ranging from 106.9 to 262.5 mL, mean hospital stay of 2.4 days, and postoperative blood transfusion rate of 19%. Oncologic outcomes showed evidence of residual disease in 21 women; 75 patients were treated with complete cytoreduction.

No evidence of intraoperative complications was observed; 6 (14.6%) postoperative complications were recorded, and the 30-day mortality rate was 9.2%. Similarly, the laparotomy conversion rate was 9.2%, primarily in complete cytoreduction achievement.

During a median follow-up period of 25.3 months, the progression-free survival (PFS) varied from 20.6 to 21.2 months and the median overall survival (OS) varied from 39.7 to 47.2 months. In 61% of women, recurrent disease was reported. These findings are in agreement (P = .02) with those from a previous study that suggested OS and PFS in the robotic arm compared with laparotomy improved significantly.1

The investigators concluded that robotic interval debulking surgery is efficient and safe when treating patients with advanced ovarian cancer who are receiving neoadjuvant chemotherapy. Larger double-blind, randomized, controlled trials may help clarify which patient populations are best suited to robotic interval debulking surgery and could benefit from this therapeutic approach.

Source: Psomiadou V, et al. Int J Gynecol Cancer. 2020;30(4_suppl). Abstract 539.

Reference
1. Psomiadou V, et al. Robotic interval debulking surgery for advanced epithelial ovarian cancer: current challenge or future direction? A systematic review [published online ahead of print, 2020 Oct 9]. J Robot Surg. 2020;10.1007/s11701-020-01155-7.

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