ORIGINAL ARTICLE Interval robotic cytoreduction following neoadjuvant chemotherapy in advanced ovarian cancer Sarah A. Ackroyd 1,2 • Sajeena Thomas 3,4 • Cynthia Angel 3,4 • Richard Moore 3,4 • Philip J. Meacham 4,5 • Brent DuBeshter 3,4 Received: 12 April 2017 / Accepted: 13 June 2017 Ó Springer-Verlag London Ltd. 2017 Abstract The objective of this study is to review our experience with robotic interval cytoreduction following neoadjuvant chemotherapy for advanced ovarian cancer. We retrospectively reviewed patients with advanced ovar- ian cancer treated with neoadjuvant chemotherapy (NAC) and interval robotic cytoreduction (IRC) between 2011 and 2016 at the University of Rochester Medical Center. Demographic information, chemotherapy treatment, oper- ative results, and follow-up were extracted from medical records. Twenty-nine patients underwent IRC after a mean of 3.9 cycles of NAC. The mean operative time was 165 min with a mean EBL of 107 cc. The mean length of stay was 2.0 days. One case (3.3%) was converted to an open procedure because of extensive tumor not amenable to robotic cytoreduction. Overall, 19 (66%) patients underwent an R0 cytoreduction, 8 (28%) an optimal ( \ 1 cm) cytoreduction, and 2 (7%) a suboptimal cytore- duction. The median overall survival was 39.7 months and median progression-free survival was 21.2 months. Inter- val robotic cytoreduction following NAC is feasible and may be preferable to open interval cytoreductive surgery, in specific patients, to minimize morbidity and length of hospital stay. Keywords Interval cytoreduction Á Neoadjuvant chemotherapy Á Robotic surgery Á Advanced ovarian cancer Introduction Ovarian cancer is the leading cause of gynecologic cancer death in the developed countries [1]. Unfortunately, only 15–20% of patients with ovarian cancer present at an early stage. Due to non-specific or absent disease symptoms, the majority of patients present with advanced disease and have a poor prognosis, with 5-year survival rates for stages IIIc and IV epithelial ovarian cancer around 39 and 17%, respectively [2]. For many years, the standard of care for Stage III and IV ovarian cancer has been primary debulk- ing surgery (PDS) followed by platinum-based adjuvant chemotherapy [3]. More recently, neoadjuvant chemotherapy (NAC) fol- lowed by interval debulking surgery has become an alter- native treatment option to primary debulking surgery (PDS). In the EORTC-NCIC randomized trial, NAC resulted in similar survival to PDS, but with lower mor- bidity [4]. Moreover, in the randomized-controlled CHORUS trial, primary chemotherapy was non-inferior to PDS, with significantly fewer postoperative deaths in the NAC group [5]. In recent years, minimally invasive approaches to a variety of gynecologic cancers, including ovarian, have been more widely adopted. While minimally invasive cytoreductive procedures are not well suited for cases with widespread disease, the use of neoadjuvant therapy prior to & Sarah A. Ackroyd Sarah.Ackroyd@TUHS.temple.edu 1 School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA 2 Department of Obstetrics, Gynecology, and Reproductive Sciences, Temple University Hospital, Philadelphia, PA, USA 3 Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA 4 JP Wilmot Cancer Institute, Rochester, NY, USA 5 Division of Epidemiology, Department of Public Health Sciences, University of Rochester, Rochester, USA 123 J Robotic Surg DOI 10.1007/s11701-017-0720-2