title: Laparoscopic Management of Ovarian Cancer Patients With Localized Carcinomatosis and Lymph Node Metastases: Results of a Retrospective Multi-institutional Series.
abstract: To investigate the feasibility and safety of laparoscopic cytoreduction in ovarian cancer patients with localized carcinomatosis or lymph node involvement.
  
  
  
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  
  Multi-institutional study performed in 6 referral gynecologic oncology units.
  
  
  
  Between June 2005 and December 2014, preoperatively presumed early-stage ovarian cancer patients, who accidentally revealed localized carcinomatosis or lymph node involvement at laparoscopic evaluation or at postoperative pathological examination managed by the laparoscopic approach.
  
  
  
  All patients with limited carcinomatosis and/or lymph node metastases underwent complete laparoscopic cytoreduction.
  
  
  
  Sixty-nine patients were included in the analysis. Twenty-eight (40.6%) patients were staged III C because they had lymph node metastases. Pelvic lymphadenectomy was performed in 75.4% of cases, whereas aortic lymphadenectomy was performed in 79.7% of cases. Lymph node metastases were found in pelvic and aortic regions in 11 and 13 patients, respectively, whereas 4 patients had lymph node metastases in both regions. Twelve (17.4%) patients underwent complete pelvic peritonectomy because of the presence of nodules localized in several pelvic region sites. As of May 2015, the median follow-up was 35 months, and the median disease-free survival was 29 months. The 2-year disease-free survival rate was 77.1%, whereas the 2-year overall survival rate was 90.6%. The median time to recurrence was 26 months (range, 6 -55 months); 15 (21.7%) patients developed recurrence.
  
  
  
  The present study shows the technical and clinical feasibility of laparoscopic cytoreduction in ovarian cancer patients with limited carcinomatosis or lymph node involvement.
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gallottav@gmail.com.
authors.forename: Valerio
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizza
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, Sacred Heart Hospital, Negrar, Verona, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceccaroni
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Gynecologic Oncology Unit, Fondazione "Giovanni Paolo II", Campobasso, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.affiliation: Department of Obstetrics and Gynecology Abano Terme Hospital, Padova, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Ercoli
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Rossitto
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Conte
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Corrado
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ferrandina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Laparoscopic cytoreduction; Laparoscopy; Minimally invasive surgery; Ovarian cancer