Surgical staging of early invasive epithelial ovarian tumors

Abstract

Early stage epithelial ovarian carcinoma is defined pathologically as a tumor strictly limited to one or both ovaries without any extra‐ovarian disease (i.e., Stage IA or B of the International Federation of Gynecology and Obstetrics (FIGO) classification). This diagnosis can be obtained only after an exhaustive surgical staging procedure, performed as soon as the diagnosis of epithelial invasive ovarian carcinoma is established. This staging surgery currently encompasses a peritoneal cytology, the thorough inspection of all the visceral and parietal peritoneal surfaces with biopsy of any abnormality, total abdominal hysterectomy and bilateral salpingo‐oophorectomy (TAH + BSO), random peritoneal biopsies, omentectomy, appendectomy and bilateral pelvic and para‐aortic lymphadenectomies, up to the left renal vein. The results of this staging procedure and its indications are discussed. In all of the cases, the radical removal of the pathologic adnexa is indicated, along with the complete peritoneal and retroperitoneal staging. While fertility‐sparing surgery (avoiding hysterectomy and contralateral adnexectomy, if possible) seems to be safe for young women, a TAH + BSO is the rule for the others. Adjuvant chemotherapy can be omitted in well‐differentiated tumors with a negative staging operation, but currently it remains indicated in all other cases. Indeed, the ultimate goal in early stage ovarian carcinoma is to not impair by inadequate management the high chance of a cure. Semin. Surg. Oncol. 19:36–41, 2000. © 2000 Wiley‐Liss, Inc.

The Safety and Efficacy of Laparoscopic Surgical Staging and Debulking of Apparent Advanced Stage Ovarian, Fallopian Tube, and Primary Peritoneal Cancers

“…In early stage ovarian cancer, multiple studies have demonstrated feasibility and efficacy of complete laparoscopic staging. 4–14 Laparoscopy offers several advantages to traditional open surgery: optical magnification of abdominal and pelvic anatomy, ease in visualization of the diaphragm and peritoneal surfaces, shorter postoperative recovery, and a decrease in length of hospital stay. 4 In advanced stage ovarian cancer, the role of laparoscopy has been described as a tool to triage for resectability and second-look evaluations, with limited studies on its role in cytoreductive procedures.…”

Prise en charge des masses annexielles organiques : résultats d’une enquête de pratique

“…Les stadifications des tumeurs frontières et malignes sont également insuffisantes et l'on peut regretter les 8 % de rupture accidentelle de tumeurs malignes [22]. Toutes les recommandations insistent sur la nécessité de cette stadification [4,[23][24][25]. Cette observation est d'autant plus surprenante que les opérateurs avaient une bonne appréciation du risque de malignité.…”

Traitement cœlioscopique des tumeurs frontières (borderline) de l'ovaire : analyse d'une série de 54 patientes et implications thérapeutiques

“…Leblanc et al ont rapporté leur expérience concernant la chirurgie de restadification des tumeurs de l'ovaire a priori de stade I [17]. Leurs résultats semblent suggérer que cette chirurgie de restadification (incluant la lymphadénectomie pelvienne et lomboaortique) est réalisable par coelioscopie.…”