Minimally invasive surgery in ovarian cancer
Laparoscopy has dramatically altered management of many gynecologic malignancies, but its utility in ovarian cancer has been limited—until now.
Second-Look Laparoscopy
Second-look surgery in women with a complete clinical response (normal exam, imaging, and CA125) after primary chemotherapy is controversial. This surgery aims to identify women with pathologically negative or microscopic disease who may benefit from consolidation therapy, or with larger-volume disease who can undergo secondary cytoreduction.27 Laparoscopy meets these goals safely with comparable accuracy and less morbidity than laparotomy.12,27
Maria’ case
lmp tumor and negative nodes
Maria did well postoperatively and went home on day 4. Her final pathology report: a right papillary serous adenocarcinoma of LMP (borderline) with small (<1 mm) foci of microinvasion. She had 6 negative paraaortic nodes, 19 negative pelvic nodes, negative pelvic washings and omentum, a normal left ovary, and a 6-cm cellular leiomyoma in an otherwise normal uterus.
She required no adjuvant treatment and is now 22 months postoperative without evidence of disease.
The authors report no financial relationships relevant to this article.
