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Comparison of Laparoscopy and Laparotomy in Surgical Staging of Early-Stage Ovarian and Fallopian Tubal Cancer

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Aim

To compare feasibility, accuracy, and safety of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer.

Methods

Outcomes of patients with stage I ovarian and fallopian tubal cancer who underwent complete surgical staging at Asan Medical Center, Korea between 2004 and 2007 were retrospectively evaluated.

Results

Nineteen patients were surgically staged through laparoscopy and 33 through laparotomy. There were no between-group differences in mean age, parity, body mass index, lymph nodes retrieved, or omentum specimen size, nor were there between-group differences in the percentage of patients who were postmenopausal, those referred for restaging, in the time interval to restaging, in those upstaged after surgery, or in those with intraoperative tumor rupture. The laparoscopy group had significantly shorter operating time (221 ± 83 min versus 275 ± 63 min, P = 0.012), less blood loss (240 ± 228 mL versus 568 ± 451 mL, P = 0.005), less transfusion requirement (5.3% versus 30.3%, P = 0.033), faster return of bowel movement (1.3 ± 0.7 days versus 3.6 ± 1.7 days. P < 0.001), and shorter postoperative hospital stay (8.9 ± 6.1 days versus 14.5 ± 5.6 days, P = 0.002) and time interval to adjuvant chemotherapy (12.8 ± 4.9 days versus 17.6 ± 8.3 days, P = 0.049). There were no postoperative complications requiring further management. After a median follow-up time of 17 months (range 1–44 months), there was no recurrence or death from disease in either group.

Conclusion

Laparotomy and laparoscopy showed similar surgical staging adequacy and accuracy, and laparoscopy showed more favorable operative outcomes. Laparoscopy was safe for early-stage ovarian and fallopian tubal cancer, although follow-up time was relatively short.

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References

  1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin 2006; 56:106–30.

    PubMed  Google Scholar 

  2. Young RC, Decker DG, Wharton JT, et al. Staging laparotomy in early ovarian cancer. JAMA 1983; 250:3072–6.

    Article  PubMed  CAS  Google Scholar 

  3. Stier EA, Barakat RR, Curtin JP, et al. Laparotomy to complete staging of presumed early ovarian cancer. Obstet Gynecol 1996; 87:737–40.

    Article  PubMed  CAS  Google Scholar 

  4. Staging announcement. FIGO cancer committee. Gyencol Oncol 1986;50:383–5.

    Google Scholar 

  5. Chi DS, Abu-Rustum NR, Sonoda Y, et al. The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers. Am J Obstet Gynecol 2005; 192:1614–9.

    Article  PubMed  Google Scholar 

  6. Ghezzi F, Cromi A, Uccella S, et al. Laparoscopy versus laparotomy for the surgical management of apparent early stage ovarian cancer. Gynecol Oncol 2007; 105:409–13.

    Article  PubMed  Google Scholar 

  7. Kuntz C, Wunsch A, Bodeker C, et al. Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy. Surg Endosc 2000; 14:367–71.

    Article  PubMed  CAS  Google Scholar 

  8. Schilling MK, Redaelli C, Krahenbuhl L, et al. Splanchnic microcirculatory changes during CO2 laparoscopy. J Am Coll Surg 1997; 184:378–82.

    PubMed  CAS  Google Scholar 

  9. Patsner B, Damien M. Umbilical metastases from a stage IB cervical cancer after laparoscopy: a case report. Fertil Steril 1992; 58:1248–9.

    PubMed  CAS  Google Scholar 

  10. Imachi M, Tsukamoto N, Kinoshita S, et al. Skin metastasis from carcinoma of the uterine cervix. Gynecol Oncol 1993; 48:349–54.

    Article  PubMed  CAS  Google Scholar 

  11. Bouvy ND, Marquet RL, Hamming JF, et al. Laparoscopic surgery in the rat. Beneficial effect on body weight and tumor take. Surg Endosc 1996; 10:490–4.

    Article  PubMed  CAS  Google Scholar 

  12. Neuhaus SJ, Watson DI, Ellis T, et al. The effect of immune enhancement and suppression on the development of laparoscopic port site metastases. Surg Endosc 2000; 14:439–43.

    Article  PubMed  CAS  Google Scholar 

  13. Targarona EM, Martinez J, Nadal A, et al. Cancer dissemination during laparoscopic surgery: tubes, gas, and cells. World J Surg 1998; 22:55–60; discussion 60–1.

    Article  PubMed  CAS  Google Scholar 

  14. Allardyce RA, Morreau P, Bagshaw PF. Operative factors affecting tumor cell distribution following laparoscopic colectomy in a porcine model. Dis Colon Rectum 1997; 40:939–45.

    Article  PubMed  CAS  Google Scholar 

  15. Lee SW, Southall J, Allendorf J, et al. Traumatic handling of the tumor independent of pneumoperitoneum increases port site implantation rate of colon cancer in a murine model. Surg Endosc 1998; 12:828–34.

    Article  PubMed  CAS  Google Scholar 

  16. Tozzi R, Kohler C, Ferrara A, et al. Laparoscopic treatment of early ovarian cancer: surgical and survival outcomes. Gynecol Oncol 2004; 93:199–203.

    Article  PubMed  Google Scholar 

  17. Leblanc E, Querleu D, Narducci F, et al. Laparoscopic restaging of early stage invasive adnexal tumors: a 10-year experience. Gynecol Oncol 2004; 94:624–9.

    Article  PubMed  CAS  Google Scholar 

  18. Pomel C, Provencher D, Dauplat J, et al. Laparoscopic staging of early ovarian cancer. Gynecol Oncol 1995; 58:301–6.

    Article  PubMed  CAS  Google Scholar 

  19. Tozzi R, Schneider A. Laparoscopic treatment of early ovarian cancer. Curr Opin Obstet Gynecol 2005; 17:354–8.

    Article  PubMed  Google Scholar 

  20. Dembo AJ, Davy M, Stenwig AE, et al. Prognostic factors in patients with stage I epithelial ovarian cancer. Obstet Gynecol 1990; 75:263–73.

    PubMed  CAS  Google Scholar 

  21. Vergote I, De Brabanter J, Fyles A, et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet 2001; 357:176–82.

    Article  PubMed  CAS  Google Scholar 

  22. Querleu D, LeBlanc E. Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube. Cancer 1994; 73:1467–71.

    Article  PubMed  CAS  Google Scholar 

  23. Childers JM, Nasseri A, Surwit EA. Laparoscopic management of suspicious adnexal masses. Am J Obstet Gynecol 1996; 175:1451–7; discussion 1457–9.

    Article  PubMed  CAS  Google Scholar 

  24. Amara DP, Nezhat C, Teng NN, et al. Operative laparoscopy in the management of ovarian cancer. Surg Laparosc Endosc 1996; 6:38–45.

    Article  PubMed  CAS  Google Scholar 

  25. Mehra G, Weekes AR, Jacobs IJ, et al. Laparoscopic extraperitoneal paraaortic lymphadenectomy: a study of its applications in gynecological malignancies. Gynecol Oncol 2004; 93:189–93.

    Article  PubMed  CAS  Google Scholar 

  26. Spirtos NM, Eisekop SM, Boike G, et al. Laparoscopic staging in patients with incompletely staged cancers of the uterus, ovary, fallopian tube, and primary peritoneum: a Gynecologic Oncology Group (GOG) study. Am J Obstet Gynecol 2005; 193:1645–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-2 dong, Songpa-gu, Seoul, 138-736, Korea

    Jeong-Yeol Park MD, Dae-Yeon Kim MD, PhD, Dae-Shik Suh MD, PhD, Jong-Hyeok Kim MD, PhD, Yong-Man Kim MD, PhD, Young-Tak Kim MD, PhD & Joo-Hyun Nam MD, PhD

Authors
  1. Jeong-Yeol Park MD
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  2. Dae-Yeon Kim MD, PhD
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  3. Dae-Shik Suh MD, PhD
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  4. Jong-Hyeok Kim MD, PhD
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  5. Yong-Man Kim MD, PhD
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  6. Young-Tak Kim MD, PhD
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  7. Joo-Hyun Nam MD, PhD
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Corresponding author

Correspondence to Joo-Hyun Nam MD, PhD.

Additional information

This paper was accepted for oral presentation at the focused plenary session of Society of Gynecologic Oncologist (SGO) 39th Annual Meeting to be held March 9–12, 2008 in Tampa, Florida, USA.

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Park, JY., Kim, DY., Suh, DS. et al. Comparison of Laparoscopy and Laparotomy in Surgical Staging of Early-Stage Ovarian and Fallopian Tubal Cancer. Ann Surg Oncol 15, 2012–2019 (2008). https://doi.org/10.1245/s10434-008-9893-2

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  • DOI: https://doi.org/10.1245/s10434-008-9893-2

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