Laparoscopic Treatment of Bulky Nodes in Primary and Recurrent Ovarian Cancer: Surgical Technique and Outcomes from Two Specialized Italian Centers

Simple Summary Epithelial ovarian cancer is typically diagnosed in the advanced stage and, despite cytoreductive surgery and medical treatments, many patients experience relapses, such as peritoneal carcinomatosis, parenchymal progression, nodal metastases, multisite disease or isolated lymph nodal recurrence. The aim of the study was to describe the principles of minimally invasive surgery in advanced and recurrent ovarian cancer with nodal involvement and analyze clinical outcomes in this setting. In our series of 21 patients undergoing laparoscopic surgery for advanced or recurrent disease with nodal metastasis, the minimally invasive approach appeared to be a safe and promising technique, with low complication rates and favorable clinical outcomes.Abstract (1) Background: Minimally invasive surgery (MIS) represents a feasible approach in early-stage ovarian cancer, while this question is still unsolved for advanced and recurrent disease. (2) Methods: In this retrospective, multicenter study, we present a series of 21 patients who underwent MIS for primitive or recurrent epithelial ovarian cancer (EOC) with bulky nodal metastasis and discuss surgical technique and outcomes in relation to the current literature. (3) Results: Complete cytoreduction at primary debulking surgery was obtained in 86% of cases. No complication occurred in our patients intraoperatively and only 11.1% of our patients experienced grade 2 and 3 postoperative complications. Notably, all the patients with isolated lymph nodal recurrence (ILNR) were successfully treated with a minimally invasive approach with no intra- or postoperative complications. (4) Conclusions: The results of our study are consistent with those reported in the literature, demonstrating that MIS may represent a safe approach in advanced and recurrent EOC with nodal metastasis if performed on selected patients by expert surgeons with an adequate setting and appropriate technique.