当院における進行卵巣がん患者に対する診断的腹腔鏡手術の現況

抄録

　Diagnostic laparoscopic surgery (lapDx) is a minimally invasive procedure that allows tissue collection and management for the definitive and genetic diagnoses of advanced ovarian cancer. We report four patients with advanced ovarian cancer who underwent lapDx from April, 2020 to July, 2022.

　The mean age of the patients was 52 years (range: 47-59), and all of them were diagnosed with high-grade serous carcinomas. The mean serum CA125 level at initial diagnosis was 2,227 U/mL (range: 927-4,130). The mean time from initial consultation to laparoscopic surgery was 11 days (range: 5-15), and chemotherapy was initiated in a mean time of 7 days (range: 6-8) postoperatively. The average operative time was 89 min (range: 65-117), and only minimal bleeding was noted. Biopsy sites were unilateral or bilateral adnexa and omentum. Three patients gave consent for HRD testing, and two tested positive. The other one tested positive for gBRCA mutation. Three patients with preoperative pleural effusion required pleural drainage before chemotherapy, and no serious postoperative complications were noted. Three patients underwent interval debulking surgery after three courses of chemotherapy, leading to complete removal. Currently, one patient is continuing chemotherapy, two patients are alive with no recurrence, and the last patient is alive with recurrent disease.

　LapDX was performed on four patients where chemotherapy was promptly done postsurgery. The pathological specimens allowed genetic diagnosis. LapDx is a useful option for patients with advanced ovarian cancer if initial complete removal is considered difficult.