Dr Hayek on Laparoscopic vs Open Surgery in Advanced Ovarian Cancer

Judy Hayek, MD, gynecologic oncology fellow, State University of New York (SUNY) Downstate College of Medicine, discusses findings regarding hospital readmission rates and mortality rates from a study comparing outcomes of minimally invasive vs open interval complete gross resection (R0) in patients with advanced ovarian cancer.

This study included 2412 patients who had undergone R0 resection at the time of interval debulking surgery, 25.9% of whom had undergone minimally invasive surgery (MIS) and 74.1% of whom had undergone open surgery or converted from MIS to open surgery. In the MIS group, 48.7% and 51.3% of patients underwent robotic and laparoscopic procedures, respectively.

Investigators observed no differences in stage, histology, and comorbidities between the population of patients who underwent MIS and those who underwent open surgery. However, the patients in the MIS group were more likely to be older than those in the open surgery group. Additionally, patients who underwent MIS were more likely to receive care at comprehensive community cancer centers located in metropolitan areas. Conversely, patients who underwent open surgery were more likely to receive extensive surgery, at 53% vs 41% in the MIS group (P < .001). This study also found that from 2010 to 2019, the rate of MIS use for interval debulking surgery increased from 11.9% to 36.5%, Hayek says.

The primary end point of this study was overall survival (OS) after interval R0 resection. Investigators found no OS difference between the open and MIS surgery groups, which achieved a median OS of 46 months and 51 months, respectively (IPTW HR, 1.10; 95% CI, 0.94-1.26; P = .17). Secondary end points in this study included hospital readmission rates, 30-day/90-day mortality rates, and length of postoperative hospital stay. Although patients in the MIS group required shorter postoperative hospital stays than those in the open surgery group, Hayek concludes.