A multicentric trial (Olympia–MITO 13) on the accuracy of laparoscopy to assess peritoneal spread in ovarian cancer

1st Evidence-based Italian Consensus Conference on Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Ovarian Cancer

“…Among these, 499 patients from 8 studies have homogenous clinical characteristics and represent the most homogenous population, on which conclusions can be drawn with a higher level of interest. In this population, the median overall survival is 37.3 months (range 27-78), the median disease-free survival is 14.4 months (range [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30], and the median 5-year overall survival is 40% (range .…”

“…The sum provides a laparoscopic score, which is unique for each patient. This is the PI, which represents the likelihood of optimal cytoreduction in percentages (22). (Level II evidence).…”

“…With the mini-invasive approach, it is possible to calculate the PCI as with a laparotomy, to perform the peritoneal washing and potential biopsies to establish the type of the primitive tumor. In addition, it allows for a predictive evaluation of the cytoreduction index and for giving a definite indication on the feasibility and the cost/benefit relationship of the CRS (20)(21)(22)(23)(24)(25)(26). (Level II evidence).…”

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

“…123,127 In select patients, minimally invasive procedures may be used to assess whether cytoreductive surgery is feasible and to achieve cytoreduction. 110,[128][129][130][131] For young patients who will abruptly enter menopause after surgery, various supportive care measures may be used to help decrease hot flashes and other symptoms. [132][133][134] Procedures that may be considered for optimal surgical cytoreduction (in all stages) include radical pelvic dissection, bowel resection and/or appendectomy, diaphragm or other peritoneal surface stripping, splenectomy, partial hepatectomy, partial gastrectomy, or partial cystectomy and/or ureteroneocystostomy, cholecystectomy, and/or distal pancreatectomy.…”

The role of laparoscopy in evaluating cytoreduction in advanced ovarian cancer

“…The knowledge of the biology and histology of the tumor must be considered mandatory in the modern age of ovarian cancer therapy. Data have shown that LPS results are reproducible even in centers with less experience with the technique, as clearly shown by the MITO 13-Olympia study [3].…”