title: Single-port or Classic Laparoscopy Compared With Laparotomy to Assess the Peritoneal Cancer Index in Primary Advanced Epithelial Ovarian Cancer.
abstract: A thorough laparoscopic assessment of the abdominopelvic cavity is a crucial step in the workup of primary advanced epithelial ovarian cancer to decide whether up-front cytoreductive surgery or neoadjuvant chemotherapy is the best option for adequate management. The purpose of our study was to compare single-port laparoscopy (SPL), classic laparoscopy (CL), and laparotomy using the peritoneal cancer index (PCI). Patients treated for Fédération Internationale de Gynécologie et d'Obstétrique stage 3 or 4 epithelial ovarian cancer were included in our study when they underwent a PCI evaluation by laparoscopy followed by laparotomy for cytoreduction. According to the technique used for the "noninvasive" procedure (SPL vs CL), 2 groups were compared retrospectively. The individual records of all patients were reviewed and analyzed. From 2011 to 2014, 21 patients were assessed for PCI by SPL plus laparotomy versus 21 by CL plus laparotomy. The clinicopathological features were similar in both groups (not significant [NS]), except for performance status >0, which was more frequent in the SPL group (39% vs 6%, p = .04). Quotation of PCI was possible for all patients. Nonbrowsing areas marked 3 procedures in the SPL group and 2 procedures in the CL group (NS). The mean PCI score and the score of each region assessed by SPL and CL were comparable with the evaluation by laparotomy (NS). Completeness of cytoreduction was achieved in 78% of cases in both groups (NS). SPL and widely mini-invasive procedures seem to be effective tools compared with laparotomy to adequately assess the resectability of a peritoneal carcinomatosis using the PCI.
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille Cedex, France. Electronic address: l-bresson@o-lambret.fr.
authors.forename: Lucie
authors.initials: L
authors.lastname: Bresson
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Clemence
authors.initials: C
authors.lastname: Allard-Duclercq
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Narducci
authors.affiliation: Department of Statistics, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Tresch
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Lesoin
authors.affiliation: Department of Anesthesia, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Abesse
authors.initials: A
authors.lastname: Ahmeidi
authors.affiliation: Department of Gynecologic Oncology, Oscar Lambret Center, Lille Cedex, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Leblanc
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging / Q000379:methods; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology* / Q000601:surgery; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
keywords: Index of peritoneal carcinomatosis; Ovarian cancer; Resectability; Single port