Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome

Am J Obstet Gynecol. 2009 Jan;200(1):83.e1-6. doi: 10.1016/j.ajog.2008.08.013. Epub 2008 Nov 18.

Abstract

Objective: To evaluate the role of laparoscopy for staging of early ovarian cancers.

Study design: Case series conducted at the University Hospital with 36 patients who had presumed early-stage adnexal cancers. Laparoscopic staging/restaging was performed.

Results: Cases included 20 invasive epithelial tumors, 11 borderline tumors, and 5 nonepithelial tumors. Mean number of peritoneal biopsies, paraaortic nodes, and pelvic nodes were 6, 12.23, and 14.84, respectively. Eighty-three percent of the patients had laparoscopic omentectomy. On final pathology, 7 patients were upstaged. Postoperative complications included 1 small bowel obstruction, 2 pelvic lymphoceles, and 1 lymphocele cyst. Mean duration of follow-up is 55.9 months. Three patients had recurrences. All patients are alive without evidence of the disease.

Conclusion: This represents 1 of the largest series and longest follow-ups of laparoscopic staging for early-stage adnexal tumors. Laparoscopic staging of these cancers appears to be feasible and comprehensive without compromising survival when performed by gynecologic oncologists experienced with advanced laparoscopy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Fallopian Tube Neoplasms / pathology
  • Fallopian Tube Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy / methods
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Retrospective Studies
  • Young Adult