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Garcia NG, Moreno CS, Teixeira N, Lloret PE, Guibourg RL, Negre RR. Comparison of Laparoscopy and Laparotomy in the Management of Early-stage Ovarian Cancer. Gynecol Minim Invasive Ther 2023; 12:83-89. [PMID: 37416098 PMCID: PMC10321349 DOI: 10.4103/gmit.gmit_99_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 07/08/2023] Open
Abstract
Objectives The objective of this study was to assess the feasibility of minimally invasive surgery for early-stage ovarian cancer (EOC) by comparing the surgical and survival outcomes between laparoscopy and laparotomy. Materials and Methods This was a retrospective, single-center observational study that included all patients who underwent surgical staging for EOC by laparoscopy or laparotomy between 2010 and 2019. Results Forty-nine patients were included; of which 20 underwent laparoscopy, 26 laparotomy, and three conversion from laparoscopy to laparotomy. No significant differences were observed between the two groups regarding operative time, number of lymph nodes dissected, or intraoperative tumor rupture rate, while estimated blood loss and transfusion requirements were lower in the laparoscopy group. The complication rate tended to be higher in the laparotomy group. Patients in the laparoscopy group had a faster recovery, with earlier urinary catheter and abdominal drain removal, shorter hospital stay, and a trend toward earlier tolerance of oral diet and mobilization. At a mean follow-up of 45.7 months, 14 patients had disease recurrence, with no differences in the mean progression-free survival between the two groups (36 months for laparoscopy vs. 35.5 months for laparotomy, P = 0.22). Conclusion Laparoscopic surgery performed by a trained gynecological oncologist is a safe and effective surgical approach for comprehensive staging of EOC, with the additional benefits of a faster recovery compared to laparotomy.
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Affiliation(s)
- Nuria Ginjaume Garcia
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
| | - Cristina Soler Moreno
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
| | - Natalia Teixeira
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
| | - Pia Español Lloret
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
| | - Rocío Luna Guibourg
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
| | - Ramon Rovira Negre
- Department of Gynecologic Oncology, Hospital De La Santa Creu I De Sant Pau, Barcelona, Spain
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Robot-assisted laparoscopic staging compared to conventional laparoscopic staging and laparotomic staging in clinical early stage ovarian carcinoma. Curr Opin Oncol 2022; 34:490-496. [PMID: 35943438 DOI: 10.1097/cco.0000000000000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Robot-assisted laparoscopic staging (RALS) is increasingly used for staging epithelial ovarian cancer (EOC). Evidence of its safety is limited. The aim of this review is to compare the efficacy and safety of RALS in clinical early-stage EOC to conventional laparoscopy and laparotomy and to assess the level of evidence that is currently available to adopt this surgical technique. RECENT FINDINGS Only retrospective studies comparing staging by minimally invasive surgery (MIS) to laparotomy are available. Both RALS and conventional laparoscopic staging shorten length of hospital stay (LHS, mean -2.9 days) and decrease estimated blood loss (EBL, mean -79 ml less) compared to laparotomy. Complication rates and number of lymph nodes collected are similar in all surgical staging techniques. Survival outcomes after staging by MIS cannot be compared to staging by laparotomy because of the lack of evidence but RALS is probably noninferior to conventional laparoscopic staging. SUMMARY RALS probably improves perioperative outcomes in patients with clinical early stage EOC similar to conventional laparoscopic staging. Whether oncologic outcomes of RALS are comparable to open and conventional approaches is uncertain as there is only level C evidence and randomized controlled trials are urgently needed to confirm the current retrospective findings.
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Cianci S, Capozzi VA, Rosati A, Rumolo V, Corrado G, Uccella S, Gueli Alletti S, Riccò M, Fagotti A, Scambia G, Cosentino F. Different Surgical Approaches for Early-Stage Ovarian Cancer Staging. A Large Monocentric Experience. Front Med (Lausanne) 2022; 9:880681. [PMID: 35547212 PMCID: PMC9081786 DOI: 10.3389/fmed.2022.880681] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Ovarian cancer is the third most frequent gynecological cancer. In early stage ovarian cancer (ESOC) comprehensive surgical staging is recommended. Surgical staging is traditionally approached by laparotomy, although minimally invasive surgery can be a valid alternative in selected patients. This study aims to analyze the surgical and oncological outcomes of three different surgical approaches in a large series of patients. Methods We retrospectively included all histologically proven ESOC cases treated between January 2014 and December 2017. ESOC was defined as stage IA to IIB according to the 2018 FIGO staging system. Subjects were divided into groups 1, 2, and 3, based on the surgical approach (open abdominal, laparoscopic, or robotic, respectively). Results Within patients enrolled during the study period, 455 met the inclusion criteria. No difference in intraoperative complications was recorded in the three groups (p = 0.709). Conversely, a significant difference occurred in postoperative complications (16.2 vs. 3.8 vs. 11.1%, in groups 1, 2, and 3 respectively, p = 0.004). No difference was found in overall survival (OS) (32 vs. 31 vs. 25 months, p = 0.481) and disease-free survival (DFS) (26 vs. 29 vs. 24 months, p = 0.178) in groups 1, 2, and 3, respectively. At univariate analysis FIGO stage I (p = 0.004) showed a lower recurrence rate compared to FIGO stage II. Conclusion No significant difference was found in OS and DFS among the three groups (open, laparoscopic, and robotic). The minimally invasive approach showed lower rate of complications than the laparotomic approach.
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Affiliation(s)
- Stefano Cianci
- Unit of Gynecology, Department of Human Pathology of Adult and Childood 'G. Barresi', University of Messina, Messina, Italy
| | - Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, Parma, Italy
| | - Andrea Rosati
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valerio Rumolo
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giacomo Corrado
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Salvatore Gueli Alletti
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Matteo Riccò
- Department of Public Health, Service for Health and Safety in the Workplace, Reggio Emilia, Italy
| | - Anna Fagotti
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Cosentino
- Department of Medicine and Health Science, "V.Tiberio" Università Degli Studi del Molise, Campobasso, Italy.,Department of Gynecologic Onocology, Gemelli Molise SpA, Campobasso, Italy
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Perioperative and Survival Outcomes of Robotic-Assisted Surgery, Comparison with Laparoscopy and Laparotomy, for Ovarian Cancer: A Network Meta-Analysis. JOURNAL OF ONCOLOGY 2022; 2022:2084774. [PMID: 35535312 PMCID: PMC9078848 DOI: 10.1155/2022/2084774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/04/2022] [Indexed: 02/08/2023]
Abstract
Objective We aimed to compare the perioperative and survival outcomes of robotic-assisted surgery, traditional laparoscopy, and laparotomy approaches in ovarian cancer. Methods PubMed, Cochrane Library, Embase, Web of Science, and Chinese National Knowledge Infrastructure (CNKI) were searched using multiple terms for ovarian cancer surgeries, including comparative studies in Chinese and English. Literatures are published before August 31, 2021. The outcomes include operating time, estimated blood loss, length of hospital stay, postoperative/intraoperative/total complications, pelvic/para-aortic/total lymph nodes, transfusion, and five-year overall survival rate. The dichotomous data, continuous data, and OS data were pooled and reported as relative risk, standardized mean differences, and hazard ratio HRs with 95% confidence intervals, respectively. The Newcastle–Ottawa Scale was used to evaluate the risk of bias of included studies. Results Thirty-eight studies, including 8,367 patients and three different surgical approaches (robotic-assisted laparoscopy surgery, traditional laparoscopy, or laparotomy approaches), were included in this network meta-analysis. Our analysis shows that the operating time of laparotomy was shorter than laparoscopy. The robotic-assisted laparoscopy has the least estimated blood loss during the surgery, followed by laparoscopy, and finally laparotomy. Compared with laparotomy, the incidence of blood transfusion was lower in the robotic-assisted laparoscopy and laparoscopy groups, and the length of hospital stay is shorter. Laparotomy had a significantly higher incidence of total complications than robotic-assisted laparoscopy and laparoscopy and higher postoperative complications than laparoscopy. For the number of pelvic/para-aortic/total lymph nodes removed by different surgical approaches, our analysis revealed no statistical difference. Our analysis also revealed no significant differences in intraoperative complications and 5-year OS among the three surgical approaches. Conclusion Compared with laparotomy, robotic-assisted laparoscopy and laparoscopy had a shorter hospital stay, decreased blood loss, fewer complications, and transfusion happened. The 5-year OS of ovarian cancer patients has no difference between robotic-assisted laparoscopy, laparoscopy, and laparotomy groups.
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Trocchi P, Mach P, Kimmig KR, Stang A. Ovarian cancer surgery in Germany: An analysis of the nationwide hospital file 2005–2015. WOMEN'S HEALTH 2022; 18:17455065221075903. [PMID: 35114854 PMCID: PMC8819748 DOI: 10.1177/17455065221075903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objectives: Nationwide hospitalization data on the surgical management of ovarian cancer
are scant. We assessed type of surgery, surgical approach, length of stay,
surgery-related complications and in-hospital mortality among women with
ovarian cancer in Germany. We analyzed nationwide hospitalization file of
2005 through 2015 including 77,589 ovarian cancer-related hospitalizations
associated with ovarian surgery. Methods: We calculated the relative frequency of the surgical approaches by type of
surgery and calendar time. We used log-binomial regression models to
estimate relative risk of in-hospital mortality (including 95% confidence
intervals) according to complications. About 63% of the hospitalizations
included an additional hysterectomy besides ovariectomy. Results: About 85% of the surgeries were performed by laparotomy. However, from
2005–2006 through 2013–2015, the proportion of laparoscopic ovariectomies
(±salpingectomy) increased from 14% to 35%. The in-hospital mortality risks
for laparotomic and laparoscopic surgery were 2.9% and 0.4%, respectively.
Adjusted mortality risk ratios varied from 1.35 (95% confidence
interval = 0.94–1.94) for bleedings requiring blood transfusion to 3.65 (95%
confidence interval = 3.31–4.03) for postoperative infections. Conclusion: We observed a tendency away from laparotomy toward laparoscopy for
ovariectomies (±salpingectomy) over time. Compared with laparotomy,
laparoscopy was associated with lower risk of complications and death. All
complications studied were associated with higher in-hospital mortality
risk.
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Affiliation(s)
- Pietro Trocchi
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital of Essen, Essen, Germany
| | - Pawel Mach
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Karl Rainer Kimmig
- Department of Obstetrics and Gynecology, University Hospital of Essen, Essen, Germany
| | - Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital of Essen, Essen, Germany
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
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Kong Q, Wei H, Zhang J, Li Y, Wang Y. Comparison of the survival outcomes of laparoscopy versus laparotomy in treatment of early-stage ovarian cancer: a systematic review and meta-analysis. J Ovarian Res 2021; 14:45. [PMID: 33726795 PMCID: PMC7968359 DOI: 10.1186/s13048-021-00793-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 03/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Laparoscopy has been widely used for patients with early-stage epithelial ovarian cancer (eEOC). However, there is limited evidence regarding whether survival outcomes of laparoscopy are equivalent to those of laparotomy among patients with eEOC. The result of survival outcomes of laparoscopy is still controversial. The aim of this meta-analysis is to analyze the survival outcomes of laparoscopy versus laparotomy in the treatment of eEOC. METHODS According to the keywords, Pubmed, Embase, Cochrane Library and Clinicaltrials.gov were searched for studies from January 1994 to January 2021. Studies comparing the efficacy and safety of laparoscopy versus laparotomy for patients with eEOC were assessed for eligibility. Only studies including outcomes of overall survival (OS) were enrolled. The meta-analysis was performed using Stata software (Version 12.0) and Review Manager (Version 5.2). RESULTS A total of 6 retrospective non-random studies were included in this meta-analysis. The pooled results indicated that there was no difference between two approaches for patients with eEOC in OS (HR = 0.6, P = 0.446), progression-free survival (PFS) (HR = 0.6, P = 0.137) and upstaging rate (OR = 1.18, P = 0.54). But the recurrence rate of laparoscopic surgery was lower than that of laparotomic surgery (OR = 0.48, P = 0.008). CONCLUSIONS Laparoscopy and laparotomy appear to provide comparable overall survival and progression-free survival outcomes for patients with eEOC. Further high-quality studies are needed to enhance this statement.
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Affiliation(s)
- Qingduo Kong
- Department of Obstetrics and Gynecology, Peking University International Hospital, Life Park of Zhongguancun, Changping District, Beijing, 102206, China.,Clinical Medical College, Weifang Medical University, Weicheng District, Weifang, 261000, Shandong, China
| | - Hongyi Wei
- Department of Obstetrics and Gynecology, Peking University International Hospital, Life Park of Zhongguancun, Changping District, Beijing, 102206, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Peking University International Hospital, Life Park of Zhongguancun, Changping District, Beijing, 102206, China
| | - Yilin Li
- Department of Obstetrics and Gynecology, Peking University International Hospital, Life Park of Zhongguancun, Changping District, Beijing, 102206, China.,Clinical Medical College, Weifang Medical University, Weicheng District, Weifang, 261000, Shandong, China
| | - Yongjun Wang
- Department of Obstetrics and Gynecology, Peking University International Hospital, Life Park of Zhongguancun, Changping District, Beijing, 102206, China.
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Bolze PA, Collinet P, Golfier F, Bourgin C. [Surgery in early-stage ovarian cancer: Article drafted from the French Guidelines in oncology entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY under the aegis of CNGOF and endorsed by INCa]. ACTA ACUST UNITED AC 2019; 47:168-179. [PMID: 30686727 DOI: 10.1016/j.gofs.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Indexed: 10/27/2022]
Abstract
Early stage ovarian epithelial cancer (stage I according to the FIGO classification, i.e. limited to ovaries) affects 20% to 33% of patients with ovarian cancer. This chapter only describes data on these presumed early stages. The rate of occult epiploic metastases varies from 2% to 4%, and leads to over-staging in stage III A of 3% to 11% of patients. Performing an omentectomy does not result in a change in survival in this situation (NP4). The rate of appendix metastasis ranges from 0% to 26.7% (NP4). In the mucinous subtype, this rate can reach 53% if the appendix is macroscopically abnormal (NP2). The rate of positive peritoneal cytology ranges from 20.9% to 27%. Positive peritoneal cytology is responsible for over-staging of patients in 4.3% to 52% of cases and appears as a poor prognostic factor on survival (NP4). The rate of occult peritoneal metastases varies from 1.1% to 16%. Performing these peritoneal biopsies results in over-staging of 4% to 7.1% (NP4). In the management of ovarian cancers at a presumed early stage, it is recommended to perform: omentectomy, peritoneal biopsies, cytology, appendectomy (grade C). In case of incomplete or incomplete initial staging, restaging including omentectomy, peritoneal biopsies and appendectomy (if not explored) is recommended; especially in the absence of a reported indication of chemotherapy. The lymph node invasion rate ranges from 6.3% to 22%. It is 4.5% to 18% for stages I and 17.5% to 31% in stages II. Between 8.5% and 13% of patients with suspected early stage ovarian cancer are reclassified to stage IIIA1 following the completion of lymphadenectomy (NP3). Pelvic and lumbo-aortic lymphadenectomy improves the survival of patients with ovarian cancer at a presumptive early stage (NP2). Pelvic and lumbo-aortic lymphadenectomy is recommended for presumed early ovarian stages (grade B). In case of initial treatment of early-stage ovarian cancer without lymph node staging, restadification including lymphadenectomy is recommended; especially in the absence of a stated indication of chemotherapy (grade B). No studies have shown any laparoscopic disadvantage compared to laparotomy for feasibility, safety, or postoperative rehabilitation (NP3) in surgical staging of patients with early-stage ovarian cancer. For the initial surgical management of these patients, the choice between laparoscopy or laparotomy depends on local conditions (tumor size) and surgical expertise. If complete surgery without risk of tumor rupture is possible, the laparoscopic approach is preferred (grade C). In the opposite case, median laparotomy is recommended. As part of surgical restadification, the laparoscopic approach is recommended (grade C). Intraoperative tumor rupture leads to a decrease in disease free survival (hazard ratio=2.28) and overall survival (hazard ratio=3.79) (NP2). It is recommended that all precautions be taken to avoid perioperative ovarian tumor rupture, including the intraoperative decision of laparoconversion (grade C). There is no specific study to answer the question of the feasibility of a one-time or two-time surgery during an extemporane diagnosis of an early stage ovarian cancer. The high sensitivity and specificity of this extemporane examination in this situation makes it possible to consider a surgical management of staging during the same operating time.
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Affiliation(s)
- P-A Bolze
- Service de chirurgie gynécologique et oncologique, obstétrique, centre hospitalier universitaire Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - P Collinet
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire de Lille, 1, rue Eugène-Avinée, 59000 Lille, France
| | - F Golfier
- Service de chirurgie gynécologique et oncologique, obstétrique, centre hospitalier universitaire Lyon Sud, université Claude-Bernard Lyon 1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - C Bourgin
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire de Lille, 1, rue Eugène-Avinée, 59000 Lille, France
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Tantitamit T, Lee CL. Is It the Time for Laparoscopic Management of Early-stage Ovarian Malignancies? Gynecol Minim Invasive Ther 2018; 7:93-103. [PMID: 30254949 PMCID: PMC6135162 DOI: 10.4103/gmit.gmit_59_18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The laparoscopic management of early-stage ovarian cancer remains controversial. Some surgeons hesitate to perform laparoscopic staging due to concern with the adequacy of staging, the possibility of tumor spillage and risk of port-site metastasis. Previous studies and literature reviews have reinforced the argument and supported the use of laparoscopy. However, the results were drawn with limited sample size obtained from case-series and case-control studies which result in difficult to make definite conclusions. Till date, the list of laparoscopic procedures has grown at a pace consistent with improvements in technology and technical skill of the surgeon. The number of studies with larger sample size, more prospective data, and longer duration of follow-up has been increasing. This review serves as an update on safety, feasibility, surgical, and oncological outcomes in cases of early-stage ovarian cancer treated by laparoscopic surgery of the literature published since 2008. We aim to clarify whether laparoscopy is safe and effective enough to be considered as standard management. Rely on nonrandomize studies, the current clinical evidence supports the role of laparoscopy in the management of early-stage ovarian cancer. Laparoscopy appears to offer several perioperative benefits without compromise of surgical morbidity and oncological outcome.
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Affiliation(s)
- Tanitra Tantitamit
- Department of Obstetrics and Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhonnayok, Taiwan
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, TaoYuan, Taiwan
| | - Chyi-Long Lee
- Department of Obstetrics and Gynecology, Linkou Chang Gung Memorial Hospital, TaoYuan, Taiwan
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, TaoYuan, Taiwan
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Falcetta FS, Lawrie TA, Medeiros LR, da Rosa MI, Edelweiss MI, Stein AT, Zelmanowicz A, Moraes AB, Zanini RR, Rosa DD. Laparoscopy versus laparotomy for FIGO stage I ovarian cancer. Cochrane Database Syst Rev 2016; 10:CD005344. [PMID: 27737492 PMCID: PMC6464147 DOI: 10.1002/14651858.cd005344.pub4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND This is an updated version of the original review that was first published in the Cochrane Database of Systematic Reviews 2008, Issue 4. Laparoscopy has become an increasingly common approach to surgical staging of apparent early-stage ovarian tumours. This review was undertaken to assess the available evidence on the benefits and risks of laparoscopy compared with laparotomy for the management of International Federation of Gynaecology and Obstetrics (FIGO) stage I ovarian cancer. OBJECTIVES To evaluate the benefits and harms of laparoscopy in the surgical treatment of FIGO stage I ovarian cancer (stages Ia, Ib and Ic) when compared with laparotomy. SEARCH METHODS For the original review, we searched the Cochrane Gynaecological Cancer Group Trials (CGCRG) Register, Cochrane Central Register of Controlled Trials (CENTRAL 2007, Issue 2), MEDLINE, Embase, LILACS, Biological Abstracts and CancerLit from 1 January 1990 to 30 November 2007. We also handsearched relevant journals, reference lists of identified studies and conference abstracts. For the first updated review, the search was extended to the CGCRG Specialised Register, CENTRAL, MEDLINE, Embase and LILACS to 6 December 2011. For this update we searched CENTRAL, MEDLINE, and Embase from November 2011 to September 2016. SELECTION CRITERIA Randomised controlled trials (RCTs), quasi-RCTs and prospective cohort studies comparing laparoscopic staging with open surgery (laparotomy) in women with stage I ovarian cancer according to FIGO. DATA COLLECTION AND ANALYSIS There were no studies to include, therefore we tabulated data from non-randomised studies (NRS) for discussion as well as important data from other meta-analyses. MAIN RESULTS We performed no meta-analyses. AUTHORS' CONCLUSIONS This review has found no good-quality evidence to help quantify the risks and benefits of laparoscopy for the management of early-stage ovarian cancer as routine clinical practice.
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Affiliation(s)
- Frederico S Falcetta
- Oncology, Hospital de Clínicas de Porto Alegre, Av. Nilópolis, 125, ap. 303, Porto Alegre, Brazil, 90460-050
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Wang PH, Horng HC, Chen CP. Is it safe to use minimally invasive surgery in the management of endometrial cancer? Taiwan J Obstet Gynecol 2016; 55:155-6. [DOI: 10.1016/j.tjog.2016.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 10/21/2022] Open
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