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Recurrence Patterns After Complete Cytoreduction for Advanced Ovarian Cancer: Robotic Versus Open Surgery
Yossi Tzur1, Yoav Brezinov1, Tomer Bar-Noy1
1Department of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, QC H3T1E2, Canada.
Background:
Complete cytoreduction remains the primary surgical objective in advanced ovarian cancer and concerns persist that robotic surgery may result in distinct recurrence patterns and worse oncologic outcomes due to technical limitations, such as the use of pneumoperitoneum, the restricted visualization, and the lack of tactile evaluation.
Methods:
We retrospectively identified 125 consecutive patients with advanced epithelial ovarian cancer who attained the best outcome surgery can achieve, and compared the outcome of these patients based on whether complete cytoreduction was achieved by laparotomy or robotic surgery. The primary objective was to compare recurrence patterns and secondary analyses assessed perioperative, postoperative, and survival outcomes.
Results:
Among 125 patients who had complete cytoreduction (78 robotic; 47 open), baseline characteristics were largely comparable, except for higher rates of interval cytoreduction (84.6% vs. 61.7%, p < 0.01) and more PARP inhibitor use (19.2% vs. 6.4%, p = 0.048) in the robotic group. Recurrence patterns did not differ. Operative and postoperative outcomes were likewise comparable. Median disease-free and overall survival were longer in the robotic group.
Conclusions:
Among patients achieving complete cytoreduction, recurrence patterns and oncologic outcomes were comparable between robotic and open surgery, suggesting that the route of attaining complete cytoreduction did not influence the outcome.
