Laparoscopic Restaging of Ovarian Cancer: Feasibility, Perioperative Outcomes and Long-Term Prognosis

Objective: To describe laparoscopic restaging of incompletely staged ovarian cancer and to compare the results with those obtained from conventional restaging via laparotomy in terms of feasibility, perioperative morbidity and prognosis. Materials and methods: From July 2004 through September 2007, 16 patients with early stage ovarian cancer underwent laparoscopic restaging. In all patients, a salpingo-oophorectomy was performed at the initial open surgery, together with a hysterectomy, omentectomy, and pelvic lymphadenectomy (LND), in some patients. Laparoscopic restaging procedures were conducted according to FIGO guidelines, which recommended infrarenal paraaortic LND, pelvic LND, and omentectomy. Perioperative parameters, recurrence rate, and overall survival were compared with those of 11 control patients treated by open restaging surgery. Results: There were no differences in the number of lymph nodes removed (laparoscopic surgery: 70; open surgery: 66). Compared to the open group, the mean blood loss was less and mean operative time was longer in the laparoscopy group. The incidence of perioperative morbidities was similar between the two groups. After a mean follow-up of 82 months, 2 of the 16 patients in the laparoscopy group suffered a recurrence and one of them died of the disease. There were no differences in overall survival between the groups. Conclusions: Laparoscopic restaging of ovarian cancer is feasible and may have advantages over open surgery in terms of lower postoperative morbidity and shorter hospital stay. No differences in prognoses were observed in this small patient series.