Feasibility and perioperative outcomes of robotic-assisted surgery in the management of recurrent ovarian cancer: a multi-institutional study.
OBJECTIVE
Minimally invasive surgery for recurrent ovarian cancer is generally not performed. The aim of this study was to assess the feasibility and surgical outcomes of robotic-assisted surgery in the management of recurrent ovarian cancer.


METHODS
Eligible patients included those with confirmed recurrent ovarian cancer amenable to surgical resection and in which a complete resection was thought to be feasible with the use of the robotic platform. Patients with evidence of carcinomatosis were not considered for a robotic approach. Clinical and pathologic data were abstracted from the medical records. Appropriate statistical tests were performed using SPSS statistical software program (SPSS 20.0 Inc., Chicago, IL).


RESULTS
A total of 48 patients were identified. Thirty-six (75%) patients had a recurrent mass or masses isolated to one anatomic region (pelvis or abdomen). Conversion to laparotomy was necessary in 4 (8.3%) cases. In cases not requiring conversion to laparotomy, the median operative time, EBL, and length of stay were 179.5 min, 50 cc, and 1 day, respectively. An optimal debulking was achieved in 36 (82%) cases. Complications occurred in 6 (13.6%) cases. The median operative time, EBL, length of stay, and complications were all statistically significantly lower in the cases not converted to laparotomy compared to those that were (p<0.001).


CONCLUSIONS
This study suggests that select patients with recurrent ovarian cancer in the absence of carcinomatosis may be candidates for secondary surgical cytoreduction via a robotic approach. Surgical and postoperative outcomes appear to be favorable compared to reports of laparotomy in recurrent ovarian cancer.
Division of Gynecologic Oncology, Cleveland Clinic, Cleveland, OH, USA; Division of Gynecologic Oncology, HIMA-San Pablo, Caguas, PR, USA. Electronic address: escobarp@mac.com.
Pedro F
PF
Escobar
Division of Gynecologic Oncology, Cleveland Clinic, Cleveland, OH, USA.
Kimberly L
KL
Levinson
Division of Gynecologic Oncology, Mayo Clinic, Scottsdale, AZ, USA.
Javier
J
Magrina
Division of Gynecologic Oncology, Lehigh Valley Health Network, PA, USA.
Martin A
MA
Martino
Division of Gynecologic Oncology, Memorial Sloan-Kettering Cancer Center, NY, USA.
Richard R
RR
Barakat
Division of Gynecologic Oncology, Johns Hopkins Medical Institutions, MD, USA.
Amanda N
AN
Fader
Division of Gynecologic Oncology, Memorial Sloan-Kettering Cancer Center, NY, USA.
Mario M
MM
Leitao
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome
Minimally invasive surgery; Robotic surgery; Surgical technique