Dr Klobocista on Minimally Invasive Gynecologic Cancer Surgery

Merieme Klobocista, MD, a gynecologic oncologist with Regional Cancer Care Associates, discusses how the surgical approach is determined for patients with gynecologic cancer and why the decision to pursue minimally invasive surgery depends on several patient-specific and disease-specific factors.

In this interview with Targeted Onc, Klobocista explains that there is no single answer to whether a patient should undergo a minimally invasive procedure. Instead, the choice depends on a close look at each individual case, beginning with the patient's history.

According to Klobocista, a patient's prior surgical procedures play an important role in planning. When a patient has undergone multiple surgeries, the type of those procedures factors into whether a minimally invasive approach can be pursued safely. Surgical history is therefore one of the first considerations weighed before the operative plan is set.

Klobocista also points to disease burden as a central factor. The question, she notes, is whether the surgeon will be able to remove the disease using a minimally invasive technique. When that is possible, minimally invasive surgery is the approach she and her colleagues prefer.

The reason for that preference, Klobocista explains, is that minimally invasive surgery is associated with better patient outcomes in terms of recovery. This recovery benefit is a driving reason the approach is favored whenever it is feasible for the individual patient.

She also describes how technology has changed gynecologic cancer surgery. The visualization provided by 3D cameras, along with the arrival of robotic surgery, has helped considerably in this setting, according to Klobocista. These advances have expanded what surgeons are able to see and accomplish during minimally invasive procedures for gynecologic malignancies.

Ultimately, Klobocista summarizes the three factors that guide the decision: the patient's history, their body habitus, and the disease burden. A patient's prior operations, including how many there have been and what they involved, help define whether a minimally invasive route is safe. Body habitus is another patient-level consideration in the surgical plan. Disease burden determines whether the surgeon can achieve removal of the disease without an open procedure. Together, these considerations determine whether a minimally invasive approach is appropriate for an individual patient with gynecologic cancer, with the goal of offering the recovery advantages of minimally invasive surgery whenever the patient's history, body habitus, and disease burden allow it.