title: Current Recommendations for Minimally Invasive Surgical Staging in Ovarian Cancer.
abstract: Minimally invasive surgery (MIS) currently is performed to stage and treat ovarian cancer at different stages of disease; however, the higher level of evidence from existing studies is IIB. Despite the absence of randomized controlled trials, MIS represents a safe and adequate procedure for treating and staging early ovarian cancer, and its use has increased significantly in clinical practice. Major concerns are related to minimizing tumor disruption or dissemination, removing the adnexal mass intact, adequate retroperitoneal staging, and fertility-sparing surgery for young patients. The main goal for patients with advanced ovarian cancer is to determine the best therapeutic strategy by evaluating the risks and benefits of primary debulking surgery versus neoadjuvant chemotherapy followed by interval debulking surgery. The use of staging laparoscopy in patients with advanced epithelial ovarian cancer appears to be the most researched and accepted approach. Regarding other types and stages of ovarian cancer, although the evidence is very promising, clinical trials performed by expert gynecologic oncology surgeons in referral centers are still needed to prove the efficacy of such an approach in these patients. In particular, MIS has provided an opportunity to remove localized recurrences, with both retroperitoneal and intraperitoneal diffusion.
authors.affiliation: Gynecologic Oncology, S. Maria Hospital, University of Perugia, Terni, Italy. annafagotti@libero.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Fagotti
authors.affiliation: Obstetrics and Gynecology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Perelli
authors.affiliation: Obstetrics and Gynecology, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pedone
authors.affiliation: Obstetrics and Gynecology, Policlinico Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D010051:Ovarian Neoplasms / Q000473:pathology* / Q000601:surgery; D017410:Practice Guidelines as Topic
keywords: Laparoscopy; MIS; Ovarian cancer; Robotics; Staging; Surgery