Minimally invasive cytoreduction for advanced-stage ovarian cancer-a narrative review

Background and Objective: Ovarian cancer is associated with high morbidity and mortality. Traditional open surgical approaches for ovarian cancer often entail extensive radical surgery leading to prolonged recovery times. Minimally invasive surgery (MIS) has become a promising alternative for gynecological malignancies, offering potential benefits such as reduced perioperative morbidity, faster recovery, and comparable oncologic outcomes. Despite increasing adoption, the role of MIS in the management of ovarian cancer requires further elucidation. This narrative review aims to summarize the current evidence on the role of MIS in the treatment of advanced-stage ovarian cancer. Specifically, it seeks to evaluate the feasibility, and oncologic outcomes associated with MIS approaches, including laparoscopic and robotic-assisted techniques. Methods: A narrative review was performed, including all pertinent publication pertaining to MIS cytoreduction for advanced stage ovarian cancer. We did not follow a systematic review pathway and included all study designs. Key Content and Findings: MIS cytoreduction for advanced stage ovarian cancer is feasible and gaining popularity, mainly in the context of increased utilization of neoadjuvant chemotherapy. No level I evidence is available regarding the oncological safety of this approach, but notwithstanding a significant risk of selection bias, retrospective data suggest that the progression-free survival and overall survival might not be jeopardised. Conclusions: In an era where lifespan, but also health span are gaining importance, tailored cytoreductive surgery using MIS could be of value for selected patients, aiming to minimize morbidity and maximize quality of life in advanced stage ovarian cancer without compromising oncologic outcomes. Based on the available published literature, MIS cytoreduction, mainly since the introduction of neo-adjuvant chemotherapy and the robotic platform, is a promising option for patients and warrants further investigation.