Laparoscopic treatment and staging of early ovarian cancer.
OBJECTIVE
To review the laparoscopic staging procedure in a series of patients with early ovarian cancer and compare results with the literature.


METHODS
A prospective single-center study (Canadian Task Force classification II-2).


METHODS
A hospital in Spain.


METHODS
A total of 20 patients with apparent early stage ovarian cancer from January 2003 through November 2007. The histologic tumor types were epithelial tumors (18 patients) and dysgerminoma (2 patients). Among the epithelial tumors, 11 were invasive and 7 were borderline (3 serous and 4 mucinous).


METHODS
Comprehensive laparoscopic staging was performed in all patients according to the International Federation of Gynecology and Obstetrics guidelines.


RESULTS
Seventeen patients had previous adnexal surgery and diagnosis and surgical staging were performed in only 3 patients during the same surgery. The patients' median age was 42.8 years (range 16-67). Eight (40%) patients desired to maintain fertility and a conservative approach was performed for this group. Laparoscopic staging was completed in 19 (95%) patients. In 1 case, a conversion to laparotomy was necessary as the para-aortic lymphadenectomy was completed because of a vessel lesion that was repaired without difficulty. The median operative time was 223 minutes (range 180-320) for radical surgery and 188 minutes (range 120-240) for the conservative approach. The mean hospital stay was 3 days. Of the 20 total patients, 4 (20%) were upstaged. The median follow-up was 24.7 months (range 1-61), with a disease-free survival of 95% and an overall survival of 100%. One recurrence was observed.


CONCLUSIONS
A comprehensive surgical staging procedure is clearly indicated in cases of early ovarian cancer and oncologic guidelines should be respected. The laparoscopic approach could be a valid alternative to laparotomy.
Unit of Oncological Gynecology, Hospital Son Llatzer, Balear Health Institute, Palma de Mallorca, Baleares, Spain. atorrent@hsll.es
Anna Torrent
AT
Colomer
Angel Martín
AM
Jiménez
M Isabel
MI
Bover Barceló
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging / Q000379:methods; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed