Abstract：
The use of the laparoscopic approach for the treatment of carcinomatosis from epithelial ovarian cancer (EOC) is controversial. The aim of this study was to compare the short-term outcomes of both laparoscopic and open approach for interval CRS+HIPEC in a matched cohort of patients with advanced EOC.
A retrospective analysis of a prospectively maintained database including 254 patients treated with interval CRS-HIPEC between January 2016 and December 2021 was performed. Patients with primary disease and limited carcinomatosis (PCI ≤ 10) were selected. A comparative analysis of patients treated by either open (O-CRS-HIPEC) or the laparoscopic (L-CRS-HIPEC) approach was conducted. Overall survival (OS), disease-free survival (DFS), and perioperative outcomes were analysed.
Fifty-three patients were finally selected and enrolled into two comparable groups in this study. Of these, 14 patients were treated by interval L-CRS-HIPEC and 39 by interval O-CRS-HIPEC. The L-CRS-HIPEC group had a shorter hospital stay (5.6 ± 1.9 vs. 9.7 ± 9.8 days; p < 0.001) and a shorter time to return to systemic chemotherapy (4.3 ± 1.9 vs. 10.3 ± 16.8 weeks; p = 0.003). There were no significant differences in postoperative complications between both groups. The 2-year OS and DFS was 100% and 62% in the L-CRS-HIPEC group versus 92% and 60% in the O-CRS-HIPEC group, respectively (p = 0.96; p = 0.786).
This study suggests that the use of interval L-CRS-HIPEC for primary advanced EOC is associated with shorter hospital stay and return to systemic treatment while obtaining similar oncological results compared to the open approach. Further prospective research is needed to recommend this new approach for these strictly selected patients.
A retrospective analysis of a prospectively maintained database including 254 patients treated with interval CRS-HIPEC between January 2016 and December 2021 was performed. Patients with primary disease and limited carcinomatosis (PCI ≤ 10) were selected. A comparative analysis of patients treated by either open (O-CRS-HIPEC) or the laparoscopic (L-CRS-HIPEC) approach was conducted. Overall survival (OS), disease-free survival (DFS), and perioperative outcomes were analysed.
Fifty-three patients were finally selected and enrolled into two comparable groups in this study. Of these, 14 patients were treated by interval L-CRS-HIPEC and 39 by interval O-CRS-HIPEC. The L-CRS-HIPEC group had a shorter hospital stay (5.6 ± 1.9 vs. 9.7 ± 9.8 days; p < 0.001) and a shorter time to return to systemic chemotherapy (4.3 ± 1.9 vs. 10.3 ± 16.8 weeks; p = 0.003). There were no significant differences in postoperative complications between both groups. The 2-year OS and DFS was 100% and 62% in the L-CRS-HIPEC group versus 92% and 60% in the O-CRS-HIPEC group, respectively (p = 0.96; p = 0.786).
This study suggests that the use of interval L-CRS-HIPEC for primary advanced EOC is associated with shorter hospital stay and return to systemic treatment while obtaining similar oncological results compared to the open approach. Further prospective research is needed to recommend this new approach for these strictly selected patients.
摘要：
背景：使用腹腔镜方法治疗上皮性卵巢癌（EOC）的癌变是有争议的。这项研究的目的是比较腹腔镜和开放方法在晚期EOC患者的匹配队列中用于间隔CRSHIPEC的短期结果。
方法：对前瞻性维护的数据库进行回顾性分析，该数据库包括2016年1月至2021年12月期间接受间隔CRS-HIPEC治疗的254例患者。选择患有原发性疾病和局限性癌（PCI≤10）的患者。对通过开放（O-CRS-HIPEC）或腹腔镜（L-CRS-HIPEC）方法治疗的患者进行了比较分析。总生存期（OS），无病生存率（DFS），分析围手术期结局。
结果：在这项研究中，最终选择了53名患者，并将其纳入两个相当的组。其中,14例患者采用区间L-CRS-HIPEC治疗，39例患者采用区间O-CRS-HIPEC治疗。L-CRS-HIPEC组住院时间较短（5.6±1.9vs.9.7±9.8天；p<0.001）和更短的时间恢复全身化疗（4.3±1.9vs.10.3±16.8周；p=0.003）。两组术后并发症比较差异无统计学意义。L-CRS-HIPEC组的2年OS和DFS分别为100％和62％，而O-CRS-HIPEC组为92％和60％，分别为(p=0.96；p=0.786)。
结论：这项研究表明，与开放方法相比，使用间隔L-CRS-HIPEC治疗原发性晚期EOC可缩短住院时间并恢复全身治疗，同时获得相似的肿瘤结果。需要进一步的前瞻性研究为这些严格选择的患者推荐这种新方法。
方法：对前瞻性维护的数据库进行回顾性分析，该数据库包括2016年1月至2021年12月期间接受间隔CRS-HIPEC治疗的254例患者。选择患有原发性疾病和局限性癌（PCI≤10）的患者。对通过开放（O-CRS-HIPEC）或腹腔镜（L-CRS-HIPEC）方法治疗的患者进行了比较分析。总生存期（OS），无病生存率（DFS），分析围手术期结局。
结果：在这项研究中，最终选择了53名患者，并将其纳入两个相当的组。其中,14例患者采用区间L-CRS-HIPEC治疗，39例患者采用区间O-CRS-HIPEC治疗。L-CRS-HIPEC组住院时间较短（5.6±1.9vs.9.7±9.8天；p<0.001）和更短的时间恢复全身化疗（4.3±1.9vs.10.3±16.8周；p=0.003）。两组术后并发症比较差异无统计学意义。L-CRS-HIPEC组的2年OS和DFS分别为100％和62％，而O-CRS-HIPEC组为92％和60％，分别为(p=0.96；p=0.786)。
结论：这项研究表明，与开放方法相比，使用间隔L-CRS-HIPEC治疗原发性晚期EOC可缩短住院时间并恢复全身治疗，同时获得相似的肿瘤结果。需要进一步的前瞻性研究为这些严格选择的患者推荐这种新方法。
