Laparoscopic treatment of early ovarian cancer: surgical and survival outcomes

Abstract Objectives . To investigate the feasibility and safety of laparoscopic surgery in patients with early ovarian cancer. Patients and methods . Between 05-1996 and 06-2003, 24 patients with ovarian cancer FIGO stage IA–B underwent either primary treatment or completion of staging by laparoscopy. Laparoscopic staging was performed according to the FIGO guidelines, which entails one-sided oophorectomy or bilateral salpingo-ophorectomy with laparoscopic-assisted vaginal hysterectomy, pelvic lymphadenectomy, infrarenal para-aortic lymphadenectomy, complete resection of the infundibulo-pelvic ligament, appendectomy and partial omentectomy. Results . Eleven out of 24 patients (45.8%) underwent completion of staging after a mean of 12 days (range 4–21) after primary surgery, while 13 patients out of 24 (54.2%) underwent primary laparoscopic management of an adnexal mass, diagnosed as ovarian cancer by frozen section. Mean operative time was 166 min (range 118–206) for completion of staging and 182 min (range 141–246) for primary surgery. No major intraoperative complication occurred. One out of 24 patients (4.1%) developed chylos ascites postoperatively, which was managed conservatively. Five out of 24 patients (20.8%) received adjuvant chemotherapy after a median time of 7 days (mean 5–14) following surgery. No trocar metastasis occurred. Median follow-up is 46.4 months (range 2–72). Two out of 24 patients (8.3%) developed recurrence, which was treated with resurgery and chemotherapy. After a median follow-up of 46 months, disease-free survival is 91.6% and overall survival 100%. Conclusions . Laparoscopic management of early ovarian cancer is safe and effective and survival outcome seems acceptable.