BACKGROUND: Laparoscopy has acquired an increasing role in the management of @entity43 . Laparoscopic cytoreduction could represent a new frontier for selected @entity1 after neoadjuvant chemotherapy (NACT). OBJECTIVE: We sought to assess feasibility and early complication rate of minimally invasive (MI) interval debulking surgery (IDS) in @entity43 ( @entity43 ) @entity1 after NACT. STUDY DESIGN: This is a phase II multicentric study in advanced @entity43 cases with clinical complete response after NACT, according to @entity5 Intergroup and Response Evaluation Criteria In @entity5 criteria. Institutional review board approval was obtained and all @entity1 signed written informed consent to be included in the protocol. The study was registered in clinicaltrials.gov (NCT02324595) and was named "MISSION" trial. For @entity1 meeting inclusion criteria, surgical procedures started with diagnostic laparoscopy to confirm preoperative findings and assess surgical complexity. MI-IDS included hysterectomy, bilateral salpingo-oophorectomy, appendectomy, omentectomy, peritonectomy, and bowel resection. Pelvic and/or aortic lymphadenectomy was not considered as standard procedure in these cases. Intraoperative and postoperative outcomes, time to restart chemotherapy, survival rate, and quality of life data were registered. RESULTS: From December 2013 through February 2015, of 184 advanced @entity43 @entity1 considered eligible for IDS, 52 (28.2%) met inclusion criteria and were enrolled in the study. For 22 (12%) of them, standard laparotomic approach was preferred because of intraoperative surgeon evaluation. Thirty (16.3%) @entity1 received the planned treatment of MI-IDS. Median age was 61 (range 39-81) years and median body mass index was 24 (range 20-31) kg/m(2). Median numbers of NACT cycles was 4 (range 3-7). Median operative time was 285 (range 124-418) minutes and median estimated @entity190 was 100 (range 50-200) mL. Surgical procedures included 28 (93.3%) hysterectomy and bilateral salpingo-oophorectomy, 29 (96.6%) omentectomy, 2 (6.6%) appendectomy, 11 (36.6%) regional peritonectomy, and 1 (3.4%) bowel resection. A @entity41 of 0 cm was reached in 29 (96.6%) @entity1 and 0.5 cm in only 1 (3.4%) case. The vast majority of @entity1 were discharged on postoperative day 2 (range 2-3). No @entity260 were registered. Median time to restart chemotherapy was 20 (10-30) days and all @entity1 successfully completed the cycles. Histological findings showed 3 (10%) complete response, 9 (30%) microscopic @entity66 , and 18 (60%) evidence of macroscopic @entity66 . With a median follow-up of 10.5 month, 5 peritoneal and 2 lymph nodal recurrences were observed. Psychometric test revealed moderate discomfort in the vast majority of @entity1 (66.7%). All @entity1 are still alive. CONCLUSION: Invasive-IDS in @entity1 with clinically complete response to NACT seems to be feasible and safe in terms of perioperative outcomes, @entity3355 , and survival rate. The equivalence between MI surgery and laparotomy needs to be confirmed with a longer follow-up and a larger number of @entity1 .

Minimally invasive interval debulking XXXX (MISSION trial-NCT02324595): a feasibility study.

@entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian cancer', 'EOC', 'stage III-IV epithelial ovarian cancer'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual tumor'] @entity3355 :: ('MESH:D014095', 'Disease') :: ['psycho-oncological impact'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Solid Tumors', 'Gynecologic Cancer'] @entity260 :: ('MESH:D011183', 'Disease') :: ['early postoperative complications']
@entity43 :: (MESH:D010051,Disease) :: ['surgery in ovarian neoplasm']
