title: Laparoscopic staging of apparent early stage ovarian cancer: results of a large, retrospective, multi-institutional series.
abstract: OBJECTIVE
  The aim of this study is to analyze the safety, adequacy, perioperative and survival figures in a large series of laparoscopic staging of patients with apparent early stage ovarian malignancies (ESOM).
  
  
  METHODS
  Retrospective data from seven gynecologic oncology service databases were searched for ESOM patients undergoing immediate laparoscopic staging or delayed laparoscopic staging after an incidental diagnosis of ESOM. Between May 2000 and February 2014, 300 patients were selected: 150 had been submitted to immediate laparoscopic staging (Group 1), while 150 had undergone delayed laparoscopic staging (Group 2) of ESOM. All surgical, pathologic, and oncologic outcome data were analyzed in each group and a comparison between the two was carried out.
  
  
  RESULTS
  Longer operative time, higher blood loss, more frequently spillage/rupture of ovarian capsule and conversion to laparotomy occurred in Group 1. No significant differences of post-operative complications were observed between the two groups. Histological data revealed more frequently serous tumors (0.06), Grade 3 (p=0.0007) and final up-staging (p=0.001) in Group 1. Recurrence and death of disease were documented in 25 (8.3%), and 10 patients (3.3%%), respectively. The 3-year disease free survival (DFS) and overall survival (OS) rates were 85.1%, and 93.6%, respectively in the whole series. There was no difference between Group 1 and Group 2 in terms of DFS (p value=0.39) and OS (p value=0.27).
  
  
  CONCLUSIONS
  In this very large multi-institutional study, it appears that patients with apparent ESOM can safely undergo laparoscopic surgical management.
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: gallottav@gmail.com.
authors.forename: V
authors.initials: V
authors.lastname: Gallotta
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ghezzi
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Vizza
authors.affiliation: Gynecologic Oncology Unit, Fondazione "Giovanni Paolo II", Campobasso, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Chiantera
authors.affiliation: Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally-Invasive Pelvic Surgery, Sacred Heart Hospital, Negrar, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ceccaroni
authors.affiliation: Department of Obstetrics and Gynecology, University of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Franchi
authors.affiliation: Division of Minimally Invasive Gynecologic Surgery, Department of Surgery, St Maria Hospital-University of Perugia, Terni, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Policlinic of Abano Terme, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ercoli
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fanfani
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Parrino
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Department of Oncological Surgery, Gynecologic Oncologic Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Corrado
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Gynecologic Oncology Unit, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Early ovarian cancer; Laparoscopy; Ovarian cancer