title: Staging laparoscopy for the management of early-stage ovarian cancer: a metaanalysis.
abstract: OBJECTIVE
  We sought to perform a quantitative analysis on operative outcomes of laparoscopic staging surgery in patients with presumed early-stage ovarian cancer using a metaanalysis.
  
  
  METHODS
  Electronic searches for studies of laparoscopic staging surgery in patients with ovarian cancer were performed within 3 electronic databases (Medline, Embase, and the Cochrane Library) using the key words "ovarian cancer," "early stage," "laparoscopy," "staging surgery," "staging laparoscopy," and "recurrence." Two authors independently screened articles, and those meeting the defined inclusion/exclusion criteria were included in the metaanalysis.
  
  
  RESULTS
  We identified 11 observational studies. The combined results of 3 retrospective studies showed that the estimated blood loss in laparoscopy was significantly lower than that for laparotomy (P < .001). The overall upstaging rate after laparoscopic surgery was 22.6% (95% confidence interval [CI], 18.1-27.9%) without significant heterogeneity among all study results. The overall incidence of conversion from laparoscopy to laparotomy was 3.7% (95% CI, 2.0-6.9%). The overall rate of recurrence in studies with a median follow-up period of ≥19 months was 9.9% (95% CI, 6.7-14.4%).
  
  
  CONCLUSIONS
  Through our quantitative analysis, we concluded that the operative outcomes of a laparoscopic approach in patients with early-stage ovarian cancer could be compatible with those of laparotomy. In the future, further randomized controlled trials may be needed.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Park
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Ga Won
authors.initials: GW
authors.lastname: Yim
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging / Q000379:methods* / Q000706:statistics & numerical data; D010051:Ovarian Neoplasms / Q000601:surgery*; D010053:Ovary / Q000601:surgery*
keywords: early-stage ovarian cancer; laparoscopy; laparotomy; operative outcomes; recurrence; staging surgery