VATS IN PATIENTS WITH ADVANCED OVARIAN MALIGNANCIES

Alexandria University68 enrolled

Overview

Ovarian cancer is the seventh most common cancer and the fifth leading cause of death in women worldwide. About 70% of patients with epithelial ovarian cancer present with advanced disease which will require a combination of cytoreductive surgery and chemotherapy to give them their best chance of long term survival.The presence of macroscopic pleural disease-especially if undetected and unresected after primary debulking surgery-may alter treatment decision-making and markedly affect survival. Video-Assisted Thoracoscopic Surgery (VATS) allows surgeons, through a minimally invasive approach, to not only drain the pleural effusion but also evaluate macroscopic pleural disease and, when possible, resect gross tumor. Few studies reported that VATS altered the therapeutic management in ovarian cancer patients leading to an upstaging or down-staging when compared to the CT staging. Therefore, this study will prospectively assess the role of VATS in the diagnosis and management of supradiaphragmatic disease as well as evaluate the impact of VATS findings on the decision of surgical management in patients with advanced ovarian cancer FIGO (The International Federation of Gynecology and Obstetrics) stage III/IV.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Ovarian Cancer

Interventions

VIDEO-ASSISTED THORACOSCOPIC SURGERY

Eligibility

Sex: FEMALEMin age: 20 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * FIGO stage III/IV ovarian cancer with or without pleural effusion Exclusion Criteria: 1. Previously treated ovarian disease. 2. Patient unfit for single lung ventilation. 3. Patients with previous lung surgery. 4. Patients with possible intrapleural adhesions. 5. Patients who had pulmonary resection.

Outcomes

Primary Outcomes

Prediction of intrathoracic disease using chest-CT results compared to the standard reference results using VATs

Comparison between the Chest-CT results in preoperative evaluation of supra-diaphragmatic disease will be compared to the intra-operative VATS evaluation results to evaluate the role of the VATS in those patients

Time frame: 3 weekS

Secondary Outcomes

The rate of change in the treatment plan according to VATs results

The number of patients that will receive different treatment plan after detection of intrathoracic disease using VATs

Time frame: 1 week