Laparoscopic Cytoreductive Surgery after Chemotherapy for Advanced Ovarian Cancer

Laparoscopic cytoreductive surgery was performed successfully in 11 women with advanced ovarian cancer after three courses of platinum-based neoadjuvant chemotherapy. Eligibility was based on the tumor response measured by a 1- to 2-log drop of CA 125, and the extent and location of disease as assessed by examination under anesthesia and diagnostic laparoscopy. All 11 women had optimal residual disease (<2 cm). Mean operating time was 1.9 hours, and mean blood loss was 210 ml. One patient (9%) required transfusion. No significant operative morbidity was encountered. The mean hospital stay was 3 days. Laparoscopic cytoreductive surgery is feasible in selected women with advanced ovarian cancer who have a significant tumor response to neoadjuvant chemotherapy.