Introduction/Background Approximately 30% of women with epithelial ovarian cancer (EOC) present in early-stage disease. Comprehensive surgical staging (CSS) including hysterectomy, bilateral salpingo-oophorectomy, cytology of ascites or peritoneal washings, peritoneal biopsies, infracolic omentectomy, pelvic and para-aortic lymphadenectomy is recommended for early epithelial ovarian cancer. However, the rates of occult metastasis detected during CSS varies in different studies. This study aimed to determine the pattern of occult metastasis and upstaging rates in patients who underwent CSS for early EOC.

Methodology This was a retrospective audit of patients who underwent primary CSS or restaging for FIGO stage 1 EOC in our institution from January 2006 to August 2023. Patients with clinical and radiological extraovarian disease and macroscopic peritoneal disease on laparotomy were excluded. The patient demographics, operative findings, and pathologic variables were analyzed

Results 76 patients who underwent CSS in the time period were included in the study. 61 underwent primary staging and 15 underwent restaging. Overall rate of occult metastasis was 35.1 percent. Most common site of metastasis was peritoneum in 11.8 percent. Occult metastasis in omentum was seen in 7.9 percent and in nodes in 10.1 percent. 18 patients (23.6%) were upstaged after CSS. 55% patients with high grade serous cancers were upstaged

Conclusion The study showed that 23.6% of clinically stage 1 EOC were upstaged due to comprehensive staging and patients with high grade serous carcinoma had highest risk of being upstaged. Thus the study highlights the role of surgical staging and the value of each of the components of staging.

Disclosures None.