J Gynecol Oncol.  2014 Apr;25(2):111-117. 10.3802/jgo.2014.25.2.111.

Comparison of laparoscopy and laparotomy for the management of early-stage ovarian cancer: surgical and oncological outcomes

• Koo YJ
• Kim JE
• Kim YH
• Hahn HS
• Lee IH
• Kim TJ
• Lee KH
• Shim JU
• Lim KT

• KMID: 1708333
• DOI: http://doi.org/10.3802/jgo.2014.25.2.111

Abstract

OBJECTIVE
To investigate the surgical and oncological outcomes of laparoscopic surgery compared with laparotomy for the treatment of early-stage ovarian cancer.
METHODS
Data from patients who underwent surgical management for early-stage ovarian cancer between 2006 and 2012 were retrospectively reviewed. All patients presented with stage I or II disease, and underwent comprehensive staging surgery consisting of a total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, omentectomy, and peritoneal cytology.
RESULTS
Seventy-seven patients who underwent laparoscopic surgery (24 patients) or laparotomy (53 patients) were identified. Surgery for none of the patients was converted from laparoscopy to laparotomy. The mean operation time was shorter and the estimated blood loss was lower in the laparoscopy group than in the laparotomy group, though the differences were not statistically significant (193 min vs. 224 min, p=0.127; 698 mL vs. 973 mL, p=0.127). There were no differences in the intraoperative or postoperative complications. During a mean follow-up period of 31 months, tumor recurrence occurred in 4 patients: 2 (8.3%) in the laparoscopy group and 2 (3.8%) in the laparotomy group. The mean disease-free survival was 59 months after laparoscopy and 66 months after laparotomy (p=0.367).
CONCLUSION
Laparoscopic surgery seems to be adequate and feasible for the treatment of early-stage ovarian cancer with comparable results to laparotomy in terms of the surgical outcomes and oncological safety.

Keyword

Early-stage ovarian cancer; Laparoscopy surgery; Laparotomy staging

MeSH Terms

Disease-Free Survival
Follow-Up Studies
Humans
Hysterectomy
Laparoscopy*
Laparotomy*
Lymph Node Excision
Ovarian Neoplasms*
Postoperative Complications
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 Kaplan-Meier analysis of the mean disease-free survival was 59.3 months (95% confidence interval [CI], 51.8 to 66.7) in the laparoscopy group and 66.3 months (95% CI, 62.8 to 69.9) in the laparotomy group with no statistically significant difference (p=0.367). The 3-year survival rate was 86.1% in the laparoscopy group and 94.7% in the laparotomy group.

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