[Impact of the surgical route on staging and outcome of early borderline ovarian tumors].
OBJECTIVE
To assess the impact of the surgical route on the management and outcome of early borderline ovarian tumors (BOT).


METHODS
We have retrospectively analysed BOT operated on between January 1st 1985 and December 31st 2001. We included cases with clinical stages Ia to Ic. We compared the prevalence of deleterious acts according to the surgical access, as well as the quality of staging. Univariate and multivariate analysis assessed the impact of factors on quality of staging. Survival was also compared according to the initial surgical access. Data were computed and analysed using SPPS 7.5 and STATA 8.


RESULTS
118 cases have been included, 48 (41%) have been operated on by laparoscopy, 54 (45%) by laparotomy and 16 (14%) had a conversion. A conservative treatment has been done in 57% of patients, with increased frequency in case of laparoscopy (P<0.05) and in aged patients (P<0.001). A tumor rupture occurred in 9% of cases, without difference between accesses (P=0.1). A bag was used for the specimen delivery in only 40% of cases of laparoscopy. Most of patients (73%) had an incomplete staging. Year of treatment, and a radical treatment were associated with a better staging. Survival curves showed no detrimental effect of laparoscopy.


CONCLUSIONS
Despite an incomplete staging, this series does not show any detrimental effect of laparoscopy on the outcome of early BOT.
Desfeux
P
P
Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges-Pompidou (HEGP), APHP, Université Paris-Descartes (Paris-V), 20, rue Leblanc, 75015 Paris, France.
Bats
A-S
AS
Bensaid
C
C
Chatellier
G
G
Blanc
B
B
Querleu
D
D
Lecuru
F
F
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome