Laparoscopic Staging of Early Ovarian Cancer

Pomel, Christophe; Provencher, Diane; Dauplat, J.; Gauthier, Philippe; Bouëdec, G. Le; Drouin, P; Audet-Lapointe, P; Dubuc-Lissoir, Josée

doi:10.1006/gyno.1995.1234

Cited by 115 publications

(27 citation statements)

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“…Laparotomy is a standard procedure for surgical restaging and previous articles reported various levels of 6 -10 . Restaging invasive ovarian carcinomas by laparoscopy has been already reported by other authors and us 11,12 . To our knowledge, there is no report concerning restaging for borderline tumours by laparoscopy.…”

Section: Introductionsupporting

confidence: 53%

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Querleu¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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Objectives To review our experience with the laparoscopic restaging procedure of presumed early stage borderline ovarian tumours. Design Retrospective study.Setting Cancer centre.Population Thirty patients with presumed stage I borderline ovarian tumours after limited initial surgery.Methods From April 1991 to May 2001, the patients were laparoscopically reassessed. The procedure involved peritoneal cytology, exploration of the peritoneal cavity, infracolic omentectomy, directed or random peritoneal biopsies, and when appropriate, contralateral oophorectomy and hysterectomy and appendectomy. Medical records were reviewed for patients' age, interval time between procedures, tumour stage, histological type, operative time, hospital stay, peri-operative complications and follow up. Main outcome measures Seroperative and postoperative data, pathology and clinical follow up.Results Laparoscopic restaging was completed in all 30 (100%) identified patients. The mean age was 34.8 (10.5) years; the delay between initial operation and restaging laparoscopy averaged 9.8 (6.6) weeks. The mean operative time was 165.4 (53.8) minutes, and the mean hospital stay was 2.7 (1.3) days. There were two (7.0%) major complications related directly to the procedure. Eight (26.6%) patients were upstaged. Mean follow up was 29.1 (6.6) months, all patients are alive and one (3.2%) recurrence was observed. Conclusions Laparoscopic approach of restaging for borderline ovarian tumours is an accurate safe procedure.It is associated with an acceptable rate of minor complications, it has similar morbidity associated with laparotomy and it minimises the incidence of infertility in the young patients. Whenever staging of borderline ovarian tumours is to be considered in an individual patient, laparoscopy provides a suitable alternative approach.

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Section: Introductionsupporting

confidence: 53%

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Querleu¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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“…Early reports confirmed the feasibility of laparoscopic staging and demonstrated that all components of the procedure could be performed laparoscopically [21, 22]. However, no long-term results were provided.…”

Section: Discussionmentioning

confidence: 99%

Trends in laparoscopic and robotic surgery among gynecologic oncologists: A survey update

Mabrouk

Frumovitz

Greer

et al. 2009

Gynecologic Oncology

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Objectives To assess the use of traditional and robotic assisted laparoscopy by Society of Gynecologic Oncology (SGO) members and to compare the results with those of our published survey in 2004. Methods Surveys were mailed to SGO members, and anonymous responses were collected by mail or through a web site. Data were analyzed and compared with those of our previous survey. In addition, we gathered information on the effect of robotic assisted surgery on the management of gynecologic malignancies. Results Three hundred eighty-eight (46%) of 850 SGO members responded to the survey. Three hundred fifty-two (91%) indicated that they performed laparoscopic surgery in their practice (compared with 84% in the 2004 survey). The three most common laparoscopic procedures were laparoscopic hysterectomy and staging for uterine cancer (43%), diagnostic laparoscopy for adnexal masses (39%), and prophylactic bilateral oophorectomy for high-risk women (11%). Although 76% of respondents had received either limited or no laparoscopic training during their fellowship, 78% now believe that maximum or much emphasis should be placed on laparoscopic training (55% in the 2004 survey). Twenty-four percent of respondents indicated that they performed robotic assisted surgery, with 66% indicating that they planned to increase their use of the procedure in the next year. Conclusions We found an overall increase in the use of and perceived indications for minimally invasive surgery in gynecologic oncology among SGO members. Endometrial cancer staging has become an accepted indication for laparoscopy. In addition, most respondents were planning on increasing their use of robotic assisted surgery in the next year.

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“…In early-stage disease, this procedure was successfully performed laparoscopically in select cases, with preliminary data suggesting comparable results with laparotomy [5,6,7,8,9,10,11]. Several main concerns have limited the widespread use of laparoscopy in place of laparotomy in ovarian cancer: the potential for inadequate staging, tumor cell peritoneal dissemination with carbon dioxide (CO 2 ) pneumoperitoneum, possibly a higher incidence of cyst rupture, and port-site metastases.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Adnexectomy with Peritonectomy for an Ovarian Tumor Adhered to the Pelvic Sidewall

Kobayashi¹,

Kanao²,

Andou³

2013

Gynecol Obstet Invest

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Laparoscopic adnexectomy is one of the most commonly used surgical techniques for the treatment of ovarian tumor. However, many physicians find it difficult to conduct the resection without rupturing the ovarian tumor, especially in cases with tumor adhesions. In the case we are presenting, we unexpectedly encountered an ovarian tumor adherent to the pelvic sidewall. Because the possibility of a malignancy could not be completely excluded, we decided to concomitantly resect the ovary and its adherent peritoneum, to avoid any potential tumor rupture due to its manipulation. We were successfully able to laparoscopically retrieve the intact ovarian tumor, without its rupture. The pathological diagnosis was of a Grade 2, FIGO stage IIb endometrioid adenocarcinoma of both ovaries. As a result of this diagnosis, we performed a comprehensive staging laparoscopy. Following the completion of adjuvant chemotherapy, the patient has showed no signs of recurrent malignancy after 3 years. This case report describes our technique for the surgical management of an ovarian tumor adherent to the pelvic wall. To avoid spillage of the tumor contents, the simultaneous resection of the tumor with its adhered peritoneum is a useful method to consider.

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Laparoscopic Staging of Early Ovarian Cancer

Cited by 115 publications

References 0 publications

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Trends in laparoscopic and robotic surgery among gynecologic oncologists: A survey update

Laparoscopic Adnexectomy with Peritonectomy for an Ovarian Tumor Adhered to the Pelvic Sidewall

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