title: Role of Video-Assisted Thoracoscopy in Advanced Ovarian Cancer: A Literature Review.
abstract: Tools that accurately predict the presence of metastatic ovarian cancer in the pleura are limited. Thus, we sought to summarize the current literature on video-assisted thoracoscopic surgery (VATS) and its applicability in patients with advanced ovarian cancer. A total of 187 patients with suspected ovarian cancer who underwent the VATS procedure were identified for this analysis. The median patient age was 59.4 years (range, 20.3-83 years). The median operative time for VATS was 32 minutes (range, 5-65 minutes). In 89 patients (48%), VATS revealed macroscopic disease in the pleural cavity. After VATS, 44 patients underwent neoadjuvant chemotherapy, and the remaining 143 patients underwent primary cytoreductive surgery. Video-assisted thoracoscopic surgery led to a change in disease stage or management in 76 patients (41%). Among patients with pleural effusions, VATS revealed pleural disease in 57% of patients, and 73% of patients with positive pleural cytology had evidence of pleural disease at the time of VATS. In addition, 23.5% of patients with negative pleural cytology had evidence of pleural disease at the time of VATS. Prospective trials are needed to accurately evaluate the impact of VATS on disease-free and overall survival in patients with advanced ovarian cancer. Video-assisted thoracoscopic surgery can help determine which patients are ideal candidates for surgical cytoreduction.
authors.affiliation: *Department of Gynecology, Hospital Británico de Buenos Aires, Buenos Aires, Argentina; †Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; and ‡Department of Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Julián
authors.initials: J
authors.lastname: Di Guilmi
authors.forename: Gloria
authors.initials: G
authors.lastname: Salvo
authors.forename: Reza
authors.initials: R
authors.lastname: Mehran
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
authors.forename: Robert L
authors.initials: RL
authors.lastname: Coleman
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.forename: Ara
authors.initials: A
authors.lastname: Vaporciyan
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000601:surgery*; D011379:Prognosis; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*