Laparoscopic Versus Laparotomy for Cytoreductive Surgery in Advanced Ovarian Cancer: A Prospective Cohort Study Comparing Surgical Outcomes, Postoperative Complications, Quality of Life, and Survival
Guiyan Yang, Jiali Yang, Yanli ChenABSTRACT
Objective
To compare surgical outcomes, postoperative complications, quality of life, and survival between laparoscopic surgery and laparotomy for cytoreductive surgery in patients with advanced ovarian cancer.
Methods
This cohort study included 60 patients with FIGO Stage III–IV advanced ovarian cancer, allocated to the control group or the study group. Quality of life was measured. Overall survival (OS), disease‐free survival (DFS), and progression‐free survival (PFS) were analyzed.
Results
Laparoscopic surgery significantly reduced operative time, blood loss, time to bowel recovery, and chemotherapy initiation. It also resulted in higher lymph node yield and optimal cytoreduction rate. Postoperative complication rates, including hypokalemia, hypoproteinemia, wound infection, and venous thrombosis, were significantly lower in the laparoscopic group. Quality of life improved significantly post‐treatment in the laparoscopic group. Five‐year OS rates were 75.0% vs. 51.9% ( p = 0.055), DFS rates were 75.0% vs. 51.9% ( p = 0.057), and PFS rates were 75.0% vs. 51.9% ( p = 0.072) for laparoscopic and laparotomy groups, respectively. Kaplan–Meier analysis showed trends favoring the laparoscopic group, with OS approaching statistical significance.
Conclusion
Laparoscopic cytoreductive surgery in advanced ovarian cancer improves perioperative outcomes, reduces complications, and enhances postoperative recovery while maintaining comparable long‐term survival outcomes to laparotomy.