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Adjuvant use of PLAsmJet device during cytoreductive surgery for advanced-stage ovarian cancer
- Source :
- Annals of Surgical Oncology, 29(8), 4833-4843. SPRINGER, Annals of Surgical Oncology, 29(8), 4833-4843. Springer, Cham, Annals of Surgical Oncology, 29(8), 4833-4843. Springer New York
- Publication Year :
- 2022
-
Abstract
- Objective Standard surgical treatment of advanced-stage ovarian carcinoma with electrosurgery cannot always result in complete cytoreductive surgery (CRS), especially when many small metastases are found on the mesentery and intestinal surface. We investigated whether adjuvant use of a neutral argon plasma device can help increase the complete cytoreduction rate. Patients and Methods 327 patients with FIGO stage IIIB–IV epithelial ovarian cancer (EOC) who underwent primary or interval CRS were randomized to either surgery with neutral argon plasma (PlasmaJet) (intervention) or without PlasmaJet (control group). The primary outcome was the percentage of complete CRS. The secondary outcomes were duration of surgery, blood loss, number of bowel resections and colostomies, hospitalization, 30-day morbidity, and quality of life (QoL). Results Complete CRS was achieved in 119 patients (75.8%) in the intervention group and 115 patients (67.6%) in the control group (risk difference (RD) 8.2%, 95% confidence interval (CI) –0.021 to 0.181; P = 0.131). In a per-protocol analysis excluding patients with unresectable disease, complete CRS was obtained in 85.6% in the intervention group and 71.5% in the control group (RD 14.1%, 95% CI 0.042 to 0.235; P = 0.005). Patient-reported QoL at 6 months after surgery differed between groups in favor of PlasmaJet surgery (95% CI 0.455–8.350; P = 0.029). Other secondary outcomes did not differ significantly. Conclusions Adjuvant use of PlasmaJet during CRS for advanced-stage ovarian cancer resulted in a significantly higher proportion of complete CRS in patients with resectable disease and higher QoL at 6 months after surgery. (Funded by ZonMw, Trial Register NL62035.078.17.) Trial Registration Approved by the Medical Ethics Review Board of the Erasmus University Medical Center Rotterdam, the Netherlands, NL62035.078.17 on 20-11-2017. Recruitment started on 30-1-2018.
- Subjects :
- Ovarian Neoplasms
RESECTION
Plasma Gases
CARCINOMA
IMPACT
ACHIEVING COMPLETE CYTOREDUCTION
Cytoreduction Surgical Procedures
Carcinoma, Ovarian Epithelial
ENERGY
NEOADJUVANT CHEMOTHERAPY
Oncology
TUMOR
SDG 3 - Good Health and Well-being
RESIDUAL DISEASE
NEUTRAL ARGON PLASMA
Quality of Life
Humans
Female
Surgery
PRIMARY DEBULKING SURGERY
Netherlands
Subjects
Details
- Language :
- English
- ISSN :
- 10689265
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology, 29(8), 4833-4843. SPRINGER, Annals of Surgical Oncology, 29(8), 4833-4843. Springer, Cham, Annals of Surgical Oncology, 29(8), 4833-4843. Springer New York
- Accession number :
- edsair.doi.dedup.....ba77e5eac0e1241577c52b5f61fbbcc3