Indications for Minimally Invasive Surgery for Ovarian Cancer

2011 ◽  
Vol 9 (1) ◽  
pp. 126-132 ◽  
Author(s):  
Ernest S. Han ◽  
Mark Wakabayashi
Keyword(s):  
Ovarian Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Surgical Debulking ◽  
Advanced Stages ◽  
Cancer Laparoscopy ◽  
Invasive Techniques ◽  
Early Stage Ovarian Cancer

Epithelial ovarian cancer is often diagnosed in advanced stages and typically managed with surgical debulking followed by chemotherapy. For patients with presumed early-stage ovarian cancer, comprehensive surgical staging is essential for management, because 31% are upstaged. Over the past 15 years, minimally invasive techniques have improved and are increasingly being used to treat patients with ovarian cancer. Currently, only retrospective data support laparoscopic staging of patients with a suspicious adnexal mass or those surgically diagnosed with presumed early-stage ovarian cancer. Laparoscopy is also used in patients undergoing second-look procedures and to help evaluate whether patients should undergo optimal tumor debulking procedures or be initially managed with neoadjuvant chemotherapy. Randomized clinical studies are needed to further support the role of minimally invasive surgery in the treatment of ovarian cancer.

scholarly journals Minimally Invasive Surgery and Risk of Capsule Rupture for Women With Early-Stage Ovarian Cancer

JAMA Oncology ◽  
2020 ◽  
Vol 6 (7) ◽  
pp. 1110 ◽  
Author(s):  
Koji Matsuo ◽  
Yongmei Huang ◽  
Shinya Matsuzaki ◽  
Maximilian Klar ◽  
Lynda D. Roman ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Early Stage Ovarian Cancer ◽  
Capsule Rupture

scholarly journals Three and Five-Year Mortality in Ovarian Cancer after Minimally Invasive Compared to Open Surgery: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (8) ◽  
pp. 2507 ◽  
Author(s):  
Floriane Jochum ◽  
Muriel Vermel ◽  
Emilie Faller ◽  
Thomas Boisrame ◽  
Lise Lecointre ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Meta Analysis ◽  
Perioperative Outcomes ◽  
Cochrane Library ◽  
Significant Difference ◽  
Advanced Stages

As regards ovarian cancer, the use of minimally invasive surgery has steadily increased over the years. Reluctance persists, however, about its oncological outcomes. The main objective of this meta-analysis was to compare the three and five-year mortality of patients operated by minimally invasive surgery (MIS) for ovarian cancer to those operated by conventional open surgery (OPS), as well as their respective perioperative outcomes. PubMed, Cochrane library and CinicalTrials.gov were systematically searched, using the terms laparoscopy, laparoscopic or minimally invasive in combination with ovarian cancer or ovarian carcinoma. We finally included 19 observational studies with a total of 7213 patients. We found no statistically significant difference for five-year (relative risk (RR) = 0.89, 95% CI 0.53–1.49, p = 0.62)) and three-year mortality (RR = 0.95, 95% CI 0.80–1.12, p = 0.52) between the patients undergoing MIS and those operated by OPS. When five and three-year recurrences were analyzed, no statistically significant differences were also observed. Analysis in early and advanced stages subgroups showed no significant difference for survival outcomes, suggesting oncological safety of MIS in all stages. Whether the surgery was primary or interval debulking surgery in advanced ovarian cancer, did not influence the comparative results on mortality or recurrence. Although the available studies are retrospective, and mostly carry a high risk for bias and confounding, an overwhelming consistency of the evidence suggests the likely effectiveness of MIS in selected cases of ovarian cancer, even in advanced stages. To validate the use of MIS, the development of future randomized interventional studies should be a priority.

scholarly journals Difficult Decisions in Minimally Invasive Surgery of the Thymus

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5887
Author(s):  
Ankit Dhamija ◽  
Jahnavi Kakuturu ◽  
J. W. Awori Hayanga ◽  
Alper Toker
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Myasthenia Gravis ◽  
Invasive Surgery ◽  
Early Stage ◽  
Disease Process ◽  
Standard Of Care ◽  
Prognostic Importance

A minimally invasive resection of thymomas has been accepted as standard of care in the last decade for early stage thymomas. This is somewhat controversial in terms of higher-staged thymomas and myasthenia gravis patients due to the prognostic importance of complete resections and the indolent characteristics of the disease process. Despite concerted efforts to standardize minimally invasive approaches, there is still controversy as to the extent of excision, approach of surgery, and the platform utilized. In this article, we aim to provide our surgical perspective of thymic resection and a review of the existing literature.

Impact of surgical approach on prevalence of positive peritoneal cytology and lymph-vascular invasion in patients with early-stage endometrial carcinoma: a National Cancer Database study

2021 ◽  
pp. ijgc-2021-002445
Author(s):  
Dimitrios Nasioudis ◽  
Emily M Ko ◽  
Lori Cory ◽  
Nawar Latif
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Endometrial Carcinoma ◽  
Invasive Surgery ◽  
Surgical Approach ◽  
Vascular Invasion ◽  
Early Stage ◽  
Tumor Grade ◽  
Peritoneal Cytology ◽  
Positive Peritoneal Cytology

ObjectiveTo investigate the prevalence of positive peritoneal cytology and lymph-vascular invasion by surgical approach among patients with early stage endometrioid endometrial carcinoma undergoing hysterectomy.MethodsThe National Cancer Database was accessed and patients with FIGO stage I endometrioid endometrial carcinoma (with no history of another tumor diagnosed) who underwent simple hysterectomy (open or minimally invasive) between January 2010 and December 2015 and had available data on the presence of lymph-vascular invasion and/or status of peritoneal cytology were selected for further analysis. The impact of a surgical approach on the odds of lymph-vascular invasion and positive peritoneal cytology was calculated after controlling for tumor grade, size, and depth of myometrial invasion.ResultsA total of 74 732 patients who met the inclusion criteria were identified. The rate of minimally invasive hysterectomy was 75.7%. Data on peritoneal cytology status and lymph-vascular invasion were available for 50 185 and 71 641 patients, respectively. A higher proportion of patients who had minimally invasive hysterectomy had positive peritoneal cytology (4.4% vs 2.3%, p<0.001), and presence of lymph-vascular invasion (10.4% vs 9.2%, p<0.001). After controlling for tumor size, tumor grade, and disease substage, the performance of minimally invasive surgery was associated with higher odds of positive peritoneal cytology (OR 2.08, 95% CI 1.83 to 2.37) and presence of lymph-vascular invasion (OR 1.33, 95% CI 1.25 to 1.41). After controlling for confounders there was no difference in survival between open and minimally invasive surgery groups (HR 0.93, 95% CI 0.85 to 1.004).ConclusionsMinimally invasive surgery may be associated with a higher incidence of positive peritoneal cytology and lymph-vascular invasion among patients with early stage endometrioid endometrial cancer. There was no difference in overall survival between patients who had laparotomy or minimally invasive surgery.

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