title: Evaluation of single-port laparoscopy for peritoneal carcinomatosis assessment in advanced ovarian cancer.
abstract: OBJECTIVE
  Ovarian cancers are usually diagnosed at an advanced stage. The extent of the disease before surgery partly determines the ability to perform a complete cytoreduction. The peritoneal cancer index (PCI) is used to evaluate peritoneal carcinomatosis and has been validated in ovarian cancer and correlated with resectability. The aim of our study was to assess the feasibility of single-port laparoscopy (SPL) for suspicion of advanced ovarian cancer and to describe the ability to calculate the PCI score at the time of laparoscopy.
  
  
  METHODS
  Between February 2011 and January 2013, 33 patients underwent SPL for suspected advanced ovarian cancer. Individual records for all patients were prospectively reviewed and analyzed. For each patient, we determined the PCI score.
  
  
  RESULTS
  33 patients underwent initial SPL, 85% had increased carcinological markers and 67% a radiological suspicion of peritoneal carcinomatosis. The median operative time was 90min. During SPL, 76% of patients underwent ascites evacuation; all patients had peritoneal cytology and peritoneal biopsies. Only 3 patients experienced perioperative complications. Two open conversions were recorded. Quotation of the PCI score was possible for all patients. Eighteen patients (55%) had a PCI score below 10; one had a maximal PCI score of 39. The PCI score was null for 9 patients. Non-browsing areas marked 8 procedures.
  
  
  CONCLUSIONS
  SPL appeared to be feasible, with satisfying immediate results and postoperative outcome, compared to conventional laparoscopy. It allowed a satisfying exploration of the abdomino-pelvic cavity and a good description of peritoneal carcinomatosis with only a few non-browsing PCI areas.
authors.affiliation: Department of General and Oncological Surgery, Paoli Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille, France. Electronic address: Delphine.quaranta@gmail.com.
authors.forename: Delphine
authors.initials: D
authors.lastname: Quaranta
authors.affiliation: Department of General and Oncological Surgery, Paoli Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Lambaudie
authors.affiliation: Department of General and Oncological Surgery, Paoli Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille, France.
authors.forename: Mellie
authors.initials: M
authors.lastname: Heinnemann
authors.affiliation: Department of General and Oncological Surgery, Paoli Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Department of General and Oncological Surgery, Paoli Calmettes Institute, 232 Boulevard Sainte-Marguerite, 13273 Marseille, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000209:etiology / Q000601:surgery; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D004322:Drainage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010051:Ovarian Neoplasms / Q000097:blood / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000556:secondary; D010537:Peritoneum / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor
keywords: Advanced ovarian cancer; PCI score; Peritoneal carcinomatosis; Single-port laparoscopy