Objective: To report the feasibility of laparoscopic cytoreduction surgery for primary and recurrent ovarian cancer in a select group of patients. Methods: A retrospective analysis was conducted on a cohort of patients with FIGO stage IIIA-IV advanced ovarian cancer who underwent laparoscopic primary debulking surgery (PDS), interval debulking surgery (IDS), or secondary debulking surgery (SDS) between June 2008 and January 2020. The primary endpoint was achieving optimal cytoreduction, defined as residual tumor less than 1 cm. Secondary endpoints included evaluating surgical complications and long-term survival, assessed at three-month intervals during the initial two years and then every six months. Results: This study included a total of 108 patients, among whom, 40 underwent PDS, 44 underwent IDS, and 24 underwent SDS. Optimal cytoreduction rates were found to be 95.0%, 97.7%, and 95.8% for the PDS, ISD, and SDS groups, respectively. Early postoperative complications (<30 days from surgery) occurred in 19.2% of cases, with 7.4% of these cases requiring reintervention. One patient died following postoperative respiratory failure. Late postoperative complications (<30 days from surgery) occurred in 9.3% of cases, and they required surgical reintervention only in one case. After laparoscopic optimal cytoreduction with a median follow-up time of 25 months, the overall recurrence rates were 45.7%, 38.5%, and 39.3% for PDS, ISD, and SDS, respectively. The three-year overall survival rates were 84%, 66%, and 63%, respectively, while the three-year disease-free survival rates were 48%, 51%, and 71%, respectively. Conclusions: Laparoscopic cytoreduction surgery is feasible for advanced ovarian cancer in carefully selected patients, resulting in high rates of optimal cytoreduction, satisfactory peri-operative morbidity, and encouraging survival outcomes. Future studies should focus on establishing standardized selection criteria and conducting well-designed investigations to further refine patient selection and evaluate long-term outcomes.
目的：探讨腹腔镜肿瘤细胞减灭术在特定原发性及复发性卵巢癌患者群体中的可行性。方法：回顾性分析2008年6月至2020年1月期间接受腹腔镜初次肿瘤细胞减灭术（PDS）、间歇性肿瘤细胞减灭术（IDS）或二次肿瘤细胞减灭术（SDS）的FIGO IIIA-IV期晚期卵巢癌患者队列。主要研究终点为达到理想肿瘤细胞减灭（定义为残留肿瘤直径<1 cm），次要终点包括评估手术并发症及长期生存情况（术后前两年每三个月评估一次，之后每六个月评估一次）。结果：本研究共纳入108例患者，其中40例接受PDS，44例接受IDS，24例接受SDS。PDS、IDS及SDS组的理想减瘤率分别为95.0%、97.7%和95.8%。术后早期并发症（<30天）发生率为19.2%，其中7.4%需再次干预，1例患者因术后呼吸衰竭死亡。术后晚期并发症（≥30天）发生率为9.3%，仅1例需手术再干预。中位随访25个月后，PDS、IDS及SDS组总复发率分别为45.7%、38.5%和39.3%，三年总生存率分别为84%、66%和63%，三年无病生存率分别为48%、51%和71%。结论：对于经严格筛选的晚期卵巢癌患者，腹腔镜肿瘤细胞减灭术具有可行性，可实现较高的理想减瘤率、令人满意的围手术期并发症发生率及良好的生存预后。未来研究应致力于建立标准化患者筛选标准，并通过精心设计的临床研究进一步优化患者选择及评估长期疗效。
肿瘤(癌症)患者之家