Staging Laparotomy In Early Ovarian Cancer

If staging laparotomy is performed in the patients with early ovarian cancer, approximately 30% of them will be subject to upstaging, from stage I to stage II/ III or from stage II to stage III. The standard staging laparotomy procedure for early ovarian cancer is as follows: peritoneal cytology of ascites/washings, multiple peritoneal surface biopsies, bilateral salpingo-oophorectomy, a total hysterectomy, pelvic and para-aortic lymphadenectomy, and omentectomy. Especially, the incidence of lymph node involvement is approximately 11% for stage I and 28% for stage II. The incidence of omental metastasis is approximately 10%. Histological diagnosis is also important. Serous carcinoma cases have a high frequency of lymph node metastasis, whereas mucinous and low-grade serous types have less frequency, and in patients with apparent mucinous-type stage I ovarian cancer, lymphadenectomy may be omitted. We believe that staging laparotomy will provide information to improve the treatment quality of patients with early ovarian cancer. If a patient is diagnosed as stage IA or IB, grade 1 ovarian cancer by surgical staging laparotomy, she has an excellent prognosis without chemotherapy. It can be omitted for patients with stage IA/IB, grade 1 disease confirmed by staging laparotomy. We believe that staging laparotomy will provide information to improve the survival of patients with early ovarian cancer.