Minimally Invasive Surgery Is an Effective Modality for Interval Cytoreduction in Advanced Ovarian Cancer: A Multi-Institutional Study

Study Objective We sought to compare the surgical and oncologic outcomes of minimally-invasive surgery (MIS), including laparoscopic (L-IDS) and robotic-assisted (R-IDS), versus laparotomy (O-IDS) in patients with advanced epithelial ovarian cancer (EOC) undergoing neoadjuvant chemotherapy (NAC). Design Demographic, clinical, and pathologic factors were abstracted from electronic medical records. Progression-free survival (PFS) and overall survival (OS) were analyzed on a Kaplan-Meier estimator using the log-rank method. Setting N/A Patients or Participants All consecutive patients with stages III to IV EOC who underwent NAC followed by IDS from 2008-2018 at three tertiary care centers were included in this retrospective cohort study. Interventions N/A Measurements and Main Results A total of 415 patients underwent IDS through L-IDS (n=78), R-IDS (n=44), or O-IDS (n=293). The median age of diagnosis was 65.2 and did not differ between MIS and open cohorts (p=0.1). MIS patients underwent more NAC cycles (4.1 vs 3.8, p=0.05) and less adjuvant cycles (3.0 vs 3.4, p=0.01); total cycles received were nodifferent (7.0 vs 7.2, p=0.3). Rates of R0 (66% vs 46%, p Conclusion MIS is feasible and effective for IDS after NAC in patients with advanced EOC. Surgical outcomes appear to be advantageous in MIS compared with O-IDS, and oncologic outcomes appear to be no different.