Diagnostic Laparoscopy for Advanced Ovarian, Fallopian Tube, and Peritoneal Cancers: A Retrospective Study.

Objectives: Despite advancements in the management of advanced ovarian, fallopian tube, and peritoneal cancers, there remains a need to explore safe and effective diagnostic techniques, particularly in cases where primary debulking surgery (PDS) is challenging. This retrospective study aimed to investigate the safety and availability of diagnostic laparoscopy for patients with advanced ovarian, fallopian tube, and peritoneal cancers.

Materials and methods: We analyzed data from 36 patients who underwent diagnostic laparoscopy between September 2017 and March 2023. The surgical outcomes of diagnostic laparoscopy and initial treatment outcomes were investigated.

Results: The median patient age was 65 years (range, 39-82 years), with majority diagnosed with high-grade serous carcinoma (HGSC). Perioperative complications were observed in 11% of patients. Neoadjuvant chemotherapy (NAC) was administered to 92% of patients, with PDS performed in two cases. Of the 33 patients who received NAC, 30 (90%) underwent interval debulking surgery, and 23 (77%) achieved complete resection. Two patients (clear-cell carcinoma and mucinous carcinoma) died of cancer before or during the initial chemotherapy. The median follow-up duration for all patients was 26.9 months. Median progression-free survival (PFS) was 19.7 months, and median overall survival was 65.5 months. In multivariate analysis, non-HGSC (hazard ratio: 3.20, 95% confidence interval [CI]: 1.07-9.61, P = 0.038) and homologous recombination proficiency (hazard ratio: 7.44, 95% CI: 1.39-39.9, P = 0.019) were risk factors for PFS.

Conclusion: Diagnostic laparoscopy is useful for intraperitoneal observation and pretreatment diagnosis in advanced ovarian, fallopian tube, and peritoneal cancers. Despite tolerable perioperative complications, further research is warranted to optimize patient outcomes.