IMR Press / EJGO / Volume 25 / Issue 5 / pii/2004236

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on as a courtesy and upon agreement with S.O.G.

Original Research

Stage I ovarian cancer: Comparison of laparoscopy and laparotomy on staging and survival

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1 Service de Chirurgie Gynécologique et Cancérologique, H?pital Européen Georges Pompidou, Faculté de Médecine Necker Enfants Malades, Paris (France)
2 Centre Investigation Clinique, H?pital Européen Georges Pompidou, Paris (France)
3 Matemité de la Conception, Marseille, Toulouse (France)
4 Centre Claudius Regaud, Toulouse (France)
Eur. J. Gynaecol. Oncol. 2004, 25(5), 571–576;
Published: 10 October 2004

Objective: The aim of this study was to compare staging accurateness as well as survival when managing early ovarian cancers by laparoscopy or laparotomy. Material and methods: We have conducted a retrospective and multicentric study in France. Only Stage I ovarian epithelial cancers operated on from January I, 1985 to December 31, 1999 were taken into account. Respondents had to fill in a form detail­ing in each case the surgical access; the surgical acts performed during the initial intervention as well as data on the patient's follow­up. Lack of follow-up or final Stage > I were considered as exclusion criteria. Data were recorded and analysed with SPSS 7.5 and STATA (Stata statistical sofware 7.0). (ANOVA, chi-square test or Fisher's exact test and log-rank test). Results: 105 cases were included: 14 patients were exclusively operated on by laparoscopy (group 1), 13 other patients were sub­jected to a conversion from laparoscopy to laparotomy (group 2) and 78 patients exclusively underwent laparotomy (group 3). Patients in group 3 were significantly more frequently postmenopausal and had larger lesions. Cyst rupture was rare during laparoscopy (21%) and the use of an endobag was achieved in only 21 % of the patients in group 1. Radical treatment was signifi­cantly more frequent in group 3 when compared to group 1 (67% vs 23%, p < 0.05). Laparoscopy was not adequate for staging since no lymphadenectomy was carried out by this approach. However, only 27% of patients subjected to an open approach under­went lymphadenectomy and omentectomy. The outcome in terms of survival was similar in the three groups with a mean follow­up period of 1,221 days (± 832) (p = 0.1). Conclusion: Laparoscopic management of early ovarian cancer is poorly efficient in staging although disease-free survival does not seem to be affected. Further evaluation of laparoscopy in this indication is needed.

Ovarian cancer
Stage I
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