Laparoscopic Splenectomy for Secondary Cytoreduction in Ovarian Cancer Patients With Localized Spleen Recurrence: Feasibility and Technique

Abstract

Study objective: To investigate the feasibility of laparoscopic splenectomy in patients with recurrent ovarian cancer with isolated spleen metastasis.

Design: (Canadian Task Force classification III).

Setting: Tertiary referral centre in Rome, Italy.

Patients: Eight women with an isolated platinum-sensitive splenic relapse of ovarian cancer.

Intervention: Between February 2013 and May 2015, 8 women with an isolated platinum-sensitive splenic relapse of ovarian cancer were submitted to laparoscopic splenectomy.

Measurements and main results: All patients underwent laparoscopic splenectomy without conversion to an open approach. The median estimated intraoperative blood loss was 100 mL (range, 50-200 mL). The median operating room time was 200 minutes (range, 80-275 mL). No intraoperative complication occurred, and no intraoperative blood transfusions were required. The median length of hospital stay was 3 days (range, 2-5 days). Complete tumor resection was achieved in all patients. The median interval from surgery to adjuvant chemotherapy was 16 days (range, 14-24 days). After a median follow-up of 23 months (range, 6-32 months), no secondary recurrence or death of disease has been observed.

Conclusion: Our findings indicate that a laparoscopic approach for spleen removal is feasible in selected patients with a splenic relapse of ovarian cancer when performed in a tertiary referral center by a well-trained surgeon.

Keywords: Laparoscopy; recurrent ovarian cancer; splenectomy.