Laparoscopy staging of early ovarian cancer: our experience and review of the literature.
We report our experience with laparoscopic staging of apparent early ovarian cancer, and we critically review the current literature on this issue. Potential limits of laparoscopic technique and theoretical concerns of using pneumoperitoneum-based surgery in this setting are addressed.


METHODS
Surgical, pathological, and oncological outcome data of consecutive patients undergoing comprehensive laparoscopic staging for presumed early ovarian cancer at our institution were prospectively collected.


RESULTS
The median operative time was 348 minutes (range, 255-450 minutes). The median estimated blood loss was 250 mL (range, 50-3000 mL). The mean number of pelvic and paraaortic lymph nodes harvested was 24.5 (SD, 6.3) and 9.8 (SD, 7.1), respectively. The disease was upstaged in 6 women (23.1%). No conversion to laparotomy and no intraoperative complication occurred. One patient had a retroperitoneal hematoma recognized in the postoperative period, and this required laparotomy and ligature of the hypogastric arteries to achieve hemostasis. The median follow-up period was 26.7 months (range, 2-83 months). Recurrence-free survival was 96.1%.


CONCLUSIONS
Our results suggest that laparoscopic comprehensive surgical staging is a valuable treatment option for ovarian cancer patients with apparent early disease. Evidence is beginning to accumulate suggesting that minimally invasive surgery is at least equivalent in surgicopathological outcomes and middle-range oncological results to the conventional treatment approach, and early concerns are proving largely unfounded.
Ghezzi
Fabio
F
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Piazza Biroldi 1, Varese, Italy. fabio.ghezzi@uninsubria.it
Cromi
Antonella
A
Siesto
Gabriele
G
Serati
Maurizio
M
Zaffaroni
Eleonora
E
Bolis
Pierfrancesco
P
D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity