Laparoscopic treatment of early ovarian cancer.
OBJECTIVE
Recently some studies have reinforced the arguments supporting the laparoscopic management of early ovarian cancer. These studies and reports questioning the use of laparoscopy in patients with early ovarian cancer will be reviewed.


RESULTS
Advances in laparoscopic techniques have enabled the surgeon to meet the staging criteria for early ovarian cancer as proposed by the International Federation of Gynecology and Obstetrics (FIGO) guidelines. Although some reports highlight the risk of ovarian cancer mismanagement, the safety and reliability of laparoscopic surgical staging has been demonstrated with encouraging results. However, the numbers of patients included in these studies are still insufficient to draw conclusions.


CONCLUSIONS
Clinical evidence supports the use of laparoscopy in the treatment or completion of treatment in patients diagnosed with early ovarian cancer. If strict guidelines are respected, tumor rupture, dissemination and implant on the trocar insertion sites can be avoided and survival outcomes appear not to be jeopardized. Inadequate and hazardous laparoscopic management of early ovarian cancer is to be ascribed to the lack of guidelines and to surgeons without the competence to treat early ovarian cancer rather than to the surgical technique. The excellent outcomes could encourage studies with larger sample sizes to confirm the validity of laparoscopic treatment of patients with early ovarian cancer. Unfortunately, a clinical trial is unlikely to be undertaken due to the low incidence of this disease and the even lower number of events.
Department of Gynaecologic Oncology, Royal Marsden Hospital, London, UK.
Roberto
R
Tozzi
Achim
A
Schneider
D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome