Objectives Compare outcomes of open and minimally invasive staging (MIS) for patients with early stage ovarian clear cell carcinoma (OCCC).
Methods Patients with clinical stage I OCCC, no history of another tumor and known mode of surgery, diagnosed between 2012–2015 were drawn from the National Cancer Database. Impact of MIS on overall survival (OS) of patients who at least one month of follow-up was assessed with the log-rank test. A Cox model was constructed to control for confounders.
Results A total of 1402 patients were identified; 438 (31.2%) had MIS. Conversion rate was 11.6%. Laparotomy and MIS groups were comparable in terms of age, race, insurance, co-morbidities, chemotherapy administration, rate of capsule rupture and final pathologic stage distribution. Patients who had MIS had shorter hospital stay (median 2 vs 4 days, p<0.001), smaller tumors (median 8.5 vs 12.5 cm, p<0.001) and were less likely to undergo lymphadenectomy (75.4% vs 82.5%, p=0.002), but had comparable number of lymph nodes removed (median 12 vs 14, p=0.06). Unplanned re-admission rates were comparable between MIS and open (2.1% vs 3.2%, p=0.23). There was no difference in OS between patients who had MIS (n=374) and open surgery (n=858), p=0.64; 3-year OS rates were 87.1% and 88.7% respectively. After controlling for confounders, MIS was not associated with worse survival (HR: 0.92, 95% CI: 0.65, 1.30).
Conclusions For patients with apparent early stage OCCC, open and MIS staging have similar oncologic outcomes.
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