Background
上皮卵巢癌（包括输卵管癌和原发性腹膜癌）是全球女性第八大癌症。在英国，大约有7300名妇女每年被诊断出患有卵巢癌，使卵巢癌成为英国女性第六个最常见的癌症。
有70％以上的新诊断为卵巢癌的妇女将出现晚期疾病（FIGO期III或IV疾病）。英格兰的一年生存率从98.0％（I期）到53.8％（IV阶段）不等，第I和IV阶段的5年生存率分别为93.3％和13.4％。
镜子研究
TheMIRRORS研究（微创机器人手术，在最佳衰减卵巢癌中的作用，康复和生存）是出于改善晚期卵巢癌女性的生活而诞生的，并且是巴特勒·曼努埃尔先生的创意，她们帮助带来了第一个DA DAVinci机器人到吉尔福德。
吉尔福德（Guildford）现在是英国第一个接受机器人手术培训的震中，也是公认的最低访问手术培训和研究中心的中心。吉尔福德（Guildford）在英国使用机器人技术在妇科肿瘤学中使用了1500多个妇科肿瘤学机器人程序。
在过去的十多年中，我们看到了机器人手术如何使诊断为子宫内膜和子宫颈癌的患者受益。平均手术失血从300毫升降至50毫升，住院时间从6天到1晚。
Using the robotic platform we have increased the proportion of women with endometrial cancer who have had minimally invasive surgery from 33% to 93%. Conversion rates to open surgery have reduced from 18% to 1.7% in this time period. Length of stay in hospital for women with endometrial cancer has also reduced from a median of 6 days to 1 night.
显然，这些疾病以不同的方式影响女性。患有晚期卵巢癌的女性通常患有更广泛的疾病，这可能会因粘附而变得复杂，但是在其下方，所有手术都是相同的。两组妇女都需要子宫切除术和去除管和卵巢。主要区别是切除所有可见疾病所需的完全去除大脑和腹膜剥离。
这是卵巢癌的一个有希望的时代。
自开放以来MIRRORSwe have found that the robotic platform is uniquely suited for women with very high BMI. The robotic platform facilitates extensive resection of disease including diaphragmatic stripping, which may have been technically difficult or access limited had the surgery been approached via the open route.
Criticisms of minimally invasive surgery are that although it provides excellent magnified vision and precision operating, the tactile element is lacking as you are not able to feel all peritoneal surfaces, and some argue this could lead to disease being missed.
晚期卵巢癌的手术
患有晚期卵巢癌的妇女最初接受三个化学疗法的周期，然后接受“间隔缓解手术”，夹在化学疗法中间，手术后完成了三个又一次的化学疗法周期。
症结所在MIRRORSis the hope that if we are able to improve how quickly women with advanced ovarian cancer recover from their interval debulking surgery they will be able to get back to chemotherapy quicker and overall their quality of life whilst on treatment will be improved. Perhaps reducing this time off chemotherapy will help in the long run.
晚期卵巢癌手术的目的是去除所有可见疾病，以使肿瘤负担尽可能低。最终，正是化学治疗剂将在越来越被视为慢性疾病的情况下控制疾病。
这是卵巢癌的一个有希望的时代。最近，对BRCA突变患者和没有的患者批准了对肿瘤和PARP抑制剂的基因组学和PARP抑制剂的越来越多的了解。
As we get older we are more likely to develop cancer. With increasing age many women also become more frail. Not all of our patients with advanced ovarian cancer are able to contemplate or are fit enough to undergo extensive open surgery requiring post-operative high dependency support.
If we are able to provide the same surgery for a select group of women with advanced ovarian cancer and also provide them with the ability to recover and get back on to their chemotherapy quicker, we hope that this will provide positive benefits.
下一步是什么？
MIRRORS目前是一项可行性研究，评估机器人手术是否是女性喜欢并会考虑的一种选择，同时评估术中直接的术中和术后结局。一旦这项最初的可行性试验完整，我们的目标是进步镜像RCT（随机对照试验），以评估无进展生存和整体生存是否等于标准的开放手术。
Who is eligible for MIRRORS?
TheMIRRORSstudy is open to adult women with advanced ovarian/fallopian tube cancer (Stage IIIc-IVb) who have had chemotherapy before surgery, have a pelvic mass ≤8 cm and don’t have another reason for requiring open surgery such as extensive disease requiring liver or upper gastro-intestinal surgical support.MIRRORS是在吉尔福德皇家萨里县医院进行的一项单位可行性研究。一旦我们启动Mirrors RCT，我们希望扩展到更多站点。
注释