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. 2022 Nov 7;12(3):141-147.
doi: 10.4103/gmit.gmit_64_22. eCollection 2023 Jul-Sep.

Application of Minimally Invasive Surgery-Multidisciplinary Team in Advanced and Recurrent Gynecological Cancers: 10-Year Exploration and Practice

Caixia Li  1 , Zhongjie Wang  1   2 , Weihong Yang  1   3 , Guihai Ai  1 , Zhongping Cheng  1   3
Affiliations

Application of Minimally Invasive Surgery-Multidisciplinary Team in Advanced and Recurrent Gynecological Cancers: 10-Year Exploration and Practice

Caixia Li et al. Gynecol Minim Invasive Ther. .

Abstract

Objectives: The treatment of advanced and recurrent gynecological cancers (ARGCs) remains more difficult evens. This assay aims to introduce the application of minimally invasive surgery-multidisciplinary team (MIS-MDT) as well as a comprehensive evaluation and treatment program of ARGC.

Materials and methods: The diagnosis and treatment model of MDT collaboration has become a new model of clinical cancer treatment. In my country, it is in the start-up and trial stage. Our team began to explore surgical treatment of recurrent gynecological cancers in 2011 and has been committed to MDT treatment of ARGC for more than 3 years.

Results: So far, 61 patients have completed MDT treatment (28 of them were advanced gynecological cancer patients, 33 of them were recurrent gynecological cancer patients). Among them, MDT involved 43 times in gastrointestinal surgery, 21 times in urology, 5 times in the department of intractable abdominal diseases, and 5 times in other departments. After surgery, 58 patients (95%) restarted adjuvant therapy such as radiotherapy and chemotherapy. In addition, 32 patients (52.5%) underwent genetic and molecular testing, of which 14 patients (23%) accepted targeted and immunotherapy based on the testing results. After MIS-MDT treatment, the median progression-free survival of these patients was >30 months, respectively.

Conclusion: These patients have achieved good results after surgery of MDT. With continuous accumulation and summarization, we have systematically reviewed the diagnosis and treatment model of ARGC and guided clinical work as the model of Tongji Tenth Hospital (comprehensive evaluation and treatment).

Keywords: Advanced and recurrent gynecological cancers; minimally invasive surgery; multidisciplinary team.

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Conflict of interest statement

Prof. Zhongping Cheng, an editorial board member at Gynecology and Minimally Invasive Therapy, had no role in the peer review process of or decision to publish this article. The other authors declared no conflicts of interest in writing this paper.

Figures

Figure 1
Figure 1
Survival analysis of 61 patients. The color of survival curve of patients with advanced and recurrent ovarian cancer is blue. The color of survival curves of patients with cervical cancer, endometrial cancer, and other gynecological cancers are red, green, and orange, respectively
Figure 2
Figure 2
Several special surgeries with MDT treatment, especially MIS-MDT surgery. (a) Laparoscopy for anterior pelvic clearance; (b) Laparoscopic for terminal ileostomy; (c) Laparoscopic for ureteral anastomosis; (d) Large venous thrombus removal of recurrent cervical carcinoma; (e) Laparoscopic for para-aortic metastasis lymph node resection of recurrent ovarian cancer; (f) Laparoscopic for mesenteric metastasis lymph node resection of recurrent ovarian cancer. MDT: Multidisciplinary team, MIS-MDT: Minimally invasive surgery-MDT
Figure 3
Figure 3
MDT treatment model of Tongji Tenth Hospital. MIS-MDT: Minimally invasive surgery-Multidisciplinary team, TVS: Transvaginal ultrasound, VTE: Venous Thromboembolism, CT: Computed tomography, MRI: Magnetic resonance imaging, PET-CT: Positron emission tomography computed tomography
See this image and copyright information in PMC

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