Minimally Invasive Interval Debulking Surgery in Advanced Ovarian Cancer

NCT07031908 · tracked via the Priya Life Science Italy tracker

Sponsor

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Phase

Observational

Started

2025-06-15

Last updated

2025-06-22

Condition(s) studied

Ovarian Cancer

Investigational drug(s) / intervention(s)

Minimally invasive cytoreduction

Minimally invasive cytoreduction: Minimally invasive cytoreduction in patients with advanced ovarian cancer treated with 6 cycles of neoadjuvant chemotherpy

Study summary

In women with advanced epithelial ovarian cancer (AOC), neoadjuvant chemotherapy (NACT) combined with interval cytoreductive surgery and post-operative chemotherapy is an option.

Several retrospective studies have demonstrated the feasibility of minimally invasive surgery in case of a good response to neoadjuvant chemotherapy, and prospective randomised trial is currently underway to demonstrate the non-inferiority of minimally invasive surgery compared to laparotomy in patients with an optimal response after 3-4 cycles of neoadjuvant chemotherapy (LANCE trial, NCT04575935).

The aim of our study is to evaluate the feasibility of interval surgery after at least VI cycles of neoadjuvant chemotherapy with a minimally invasive approach.

Eligibility

Sex

FEMALE

Min age

18 Years

Max age

—

Healthy volunteers

Inclusion Criteria: * Stage IIIC or IV high-grade invasive epithelial ovarian carcinoma (serous, endometrioid, clear cell, transitional), primary peritoneal carcinoma, or fallopian tube carcinoma, or pathology consistent with high-grade Müllerian carcinoma. * Partial or complete radiological response of abdominal cavity disease after at least 6 cycles of neoadjuvant chemotherapy (NACT). * CA125 \< 100 U/mL. * ECOG performance status 0-1. * Signed informed consent and ability to comply with follow-up, including in cases where the patient has a legal guardian. In such cases, consent will be provided by the legal guardian. * Review of imaging by a radiologist and senior surgeon at a multidisciplinary tumor board, particularly evaluating hepatic hilum involvement, mesenteric root, extensive peritoneal disease in the upper abdomen, extensive hepatic or gastric involvement, and extensive intestinal involvement. * If all the previous criteria are met and protocol acceptance is obtained, the patient will undergo a laparoscopic evaluation of all abdominal quadrants to confirm the feasibility of minimally invasive surgery (MIS). Surgery will be considered feasible if complete gross resection can be achieved with minimally invasive surgery. If minimally invasive surgery is not feasible, the patient will be excluded from the study, and the reason for unfeasibility will be described. Exclusion Criteria: * Evidence of a tumor not amenable to minimally invasive complete resection on preoperative imaging (CT, PET-CT, or MRI). Radiologic criteria (tumor board evaluation): hepatic hilum involvement, mesentery root, extensive peritoneal disease in upper abdomen, extensive hepatic or gastric involvement, extensive intestinal involvement * Disease free of other active malignancies within the past 5 years, except basal cell carcinoma of the skin. * History of psychological, familial, sociological, or geographic conditions potentially impeding adherence to the study protocol and follow-up program * Inability to tolerate prolonged Trendelenburg position or pneumoperitoneum

Primary outcome measure(s)

Feasibility of minimally invasive surgery — 15 days
Minimally invasive surgery feasibility will be calculated on the rates of: conversion from MIS to laparotomy, complete gross resection, and protocol acceptance. In this study feasibility is defined as a conversion rate \<20%, a complete gross resection rate \>80% and the enrollment of at least 1 patient each month.
Safety of minimally invasive surgery (First parameter) — 2 years
2 Years Overall Survival defined as the interval time (months) between surgery and death or censored at the last follow-up
Safety of minimally invasive surgery (Second parameter) — 2 years
2 Years Disease Free Survival defined as the interval time (months) between surgery and the first occurrence of relapse or death due to ovarian cancer, whichever occurs first or censored at the last follow-up
Safety of minimally invasive surgery (third parameter) — 6 months
Safety will be evaluated using the following criteria: \- Rate of early and late severe post-operative complications (early: \<30days from surgery; late: more than 30 days and less then 6 months from surgery) using Clavien Dindo classification

Trial sites (1)

Facility	City	Region	Status
Fondazione Policlinico Universitario Agostino Gemelli IRCCS, UOC Ginecologia Oncologica	Roma	Italy

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Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07031908 on ClinicalTrials.gov ↗ ← All trials in Italy