title: Stage I ovarian cancer: comparison of laparoscopy and laparotomy on staging and survival.
abstract: OBJECTIVE
  The aim of this study was to compare staging accurateness as well as survival when managing early ovarian cancers by laparoscopy or laparotomy.
  
  
  METHODS
  We have conducted a retrospective and multicentric study in France. Only Stage I ovarian epithelial cancers operated on from January 1, 1985 to December 31, 1999 were taken into account. Respondents had to fill in a form detailing in each case the surgical access; the surgical acts performed during the initial intervention as well as data on the patient's follow-up. Lack of follow-up or final Stage > I were considered as exclusion criteria. Data were recorded and analysed with SPSS 7.5 and STATA (Stata statistical sofware 7.0). (ANOVA, chi-square test or Fisher's exact test and log-rank test).
  
  
  RESULTS
  105 cases were included: 14 patients were exclusively operated on by laparoscopy (group 1), 13 other patients were subjected to a conversion from laparoscopy to laparotomy (group 2) and 78 patients exclusively underwent laparotomy (group 3). Patients in group 3 were significantly more frequently postmenopausal and had larger lesions. Cyst rupture was rare during laparoscopy (21%) and the use of an endobag was achieved in only 21% of the patients in group 1. Radical treatment was significantly more frequent in group 3 when compared to group 1 (67% vs 23%, p < 0.05). Laparoscopy was not adequate for staging since no lymphadenectomy was carried out by this approach. However, only 27% of patients subjected to an open approach underwent lymphadenectomy and omentectomy. The outcome in terms of survival was similar in the three groups with a mean follow-up period of 1,221 days (+/- 832) (p = 0.1).
  
  
  CONCLUSIONS
  Laparoscopic management of early ovarian cancer is poorly efficient in staging although disease-free survival does not seem to be affected. Further evaluation of laparoscopy in this indication is needed.
authors.affiliation: Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges Pompidou, Faculté de Médecine Necker Enfants Malades, Paris (France).
authors.forename: F
authors.initials: F
authors.lastname: Lécuru
authors.forename: P
authors.initials: P
authors.lastname: Desfeux
authors.forename: S
authors.initials: S
authors.lastname: Camatte
authors.forename: A
authors.initials: A
authors.lastname: Bissery
authors.forename: F
authors.initials: F
authors.lastname: Robin
authors.forename: B
authors.initials: B
authors.lastname: Blanc
authors.forename: D
authors.initials: D
authors.lastname: Querleu
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D005260:Female; D005602:France / Q000453:epidemiology; D049671:History, 18th Century; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis