Laparoscopic management of early stage ovarian cancer: is it feasible, safe, and adequate? A retrospective study.
BACKGROUND
Minimally invasive surgery to stage early ovarian cancer is still regarded as pioneering among gynecologic oncologists. Previous retrospective experiences demonstrated the safety and feasibility of laparoscopy in this field.


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


METHODS
From January 2004 to September 2011, 19 patients with apparent early stage ovarian/fallopian tube cancer Stage IA to IC underwent either primary treatment or completion staging by laparoscopy. Surgical, pathologic, and oncologic outcomes were analyzed.


RESULTS
The mean operative time was 212 +/- 69 minutes. Three patients (16%) underwent fertility sparing surgery. The mean estimated blood loss was two +/- two g/dl. The mean number of pelvic and para-aortic lymph nodes collected was 17 (range 7-27) and 14 (range 8-21), respectively. The mean volume of ovarian/tubal tumor was 119 cm3 (range 1.5-500). The disease was reclassified to a higher stage in ten women (52%). One major intraoperative complication (five percent) occurred which required the conversion to laparotomy. The mean follow up period was 30 +/- 16 months (range 10-74). Overall survival and disease-free survival were 100% and 84%, respectively.


CONCLUSIONS
Laparoscopic staging of early ovarian cancer appears to be feasible and comprehensive when performed by gynecologic oncologists experienced with advanced laparoscopy.
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
G
G
Montanari
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
N
N
Di Donato
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
S
S
Del Forno
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
A
A
Benfenati
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
V
V
Bertoldo
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
C
C
Vincenzi
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
P
P
Casadio
Minimally Invasive Gynecological Surgery Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy.
R
R
Seracchioli
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies