VATS IN PATIENTS WITH ADVANCED OVARIAN MALIGNANCIES

Study Overview
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Brief Summary
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Ovarian cancer is the seventh most common cancer and the fifth leading cause of death in women worldwide. About 70% of patients with epithelial ovarian cancer present with advanced disease which will require a combination of cytoreductive surgery and chemotherapy to give them their best chance of long term survival.The presence of macroscopic pleural disease-especially if undetected and unresected after primary debulking surgery-may alter treatment decision-making and markedly affect survival. Video-Assisted Thoracoscopic Surgery (VATS) allows surgeons, through a minimally invasive approach, to not only drain the pleural effusion but also evaluate macroscopic pleural disease and, when possible, resect gross tumor. Few studies reported that VATS altered the therapeutic management in ovarian cancer patients leading to an upstaging or down-staging when compared to the CT staging. Therefore, this study will prospectively assess the role of VATS in the diagnosis and management of supradiaphragmatic disease as well as evaluate the impact of VATS findings on the decision of surgical management in patients with advanced ovarian cancer FIGO (The International Federation of Gynecology and Obstetrics) stage III/IV.

Official Title
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THE ROLE OF VIDEO-ASSISTED THORACOSCOPIC SURGERY IN PATIENTS WITH ADVANCED OVARIAN MALIGNANCIES

Conditions
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Ovarian Cancer

Intervention / Treatment
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* Procedure: VIDEO-ASSISTED THORACOSCOPIC SURGERY


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: FIGO stage III/IV ovarian cancer with or without pleural effusion Exclusion Criteria: Previously treated ovarian disease. Patient unfit for single lung ventilation. Patients with previous lung surgery. Patients with possible intrapleural adhesions. Patients who had pulmonary resection.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A: Patients who will get neoadjuvant chemotherapy based on VATS finding.<br>Patients will be considered to receive neoadjuvant chemotherapy if there is residual intrathoracic disease | Procedure: VIDEO-ASSISTED THORACOSCOPIC SURGERY<br>* A minimally invasive approach, to not only drain the pleural effusion but also evaluate macroscopic pleural disease and, when possible, resect gross tumor.<br>* Other names: VATS;|
| Group B: Patients who will proceed into debulking surgery based on VATS finding.<br>Patients will be considered to be eligible for complete debulking, if VATS showed no intrathoracic tumor or if VATS achieves complete removal of tumor nodules through intraoperative frozen section histopathological examination. | Procedure: VIDEO-ASSISTED THORACOSCOPIC SURGERY<br>* A minimally invasive approach, to not only drain the pleural effusion but also evaluate macroscopic pleural disease and, when possible, resect gross tumor.<br>* Other names: VATS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prediction of intrathoracic disease using chest-CT results compared to the standard reference results using VATs | Comparison between the Chest-CT results in preoperative evaluation of supra-diaphragmatic disease will be compared to the intra-operative VATS evaluation results to evaluate the role of the VATS in those patients | 3 weekS | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of change in the treatment plan according to VATs results | The number of patients that will receive different treatment plan after detection of intrathoracic disease using VATs | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ovarian cancer stage III, IV; VATS, CT staging