Is it enough in ovarian cancer staging surgery to laparoscopic surgery? Comparison of surgical methods

Objective: This study was carried out to compare conventional laparotomy with laparoscopic surgery for ovarian cancer and identify no difference between conventional laparotomy and laparoscopic surgery for advanced ovarian cancer. Materials and Methods: Targeting 249 patients, who had been diagnosed with ovarian cancer and had undergone treatment in general university hospitals over ten years, this study was conducted with two gynecologic oncologists. The patients were placed in a laparotomy group (group 1) and a laparoscopic surgery group (including robotic surgery) (group 2). Results: One hundred ninety-two of a total of 249 patients belonged to the laparotomy group and 57 patients belonged to the laparoscopic surgery group. With regards to ovarian cancer staging, 80 of 249 (32.1%) patients were in Stage I-II and 129 of 249 patients were in Stage III-IV. Twenty of 249 (8%) patients (16 of 192 patients in group 1, 4 of 57 patients in group 2) suffered from operative complications and one great vessel injury was found in group 1. Sixty-nine of 249 patients (27.7%) [58 of 192 patients in group 1 (30.2%) and 11 of 57 patients in group 2 (19.2%)] had a relapse. In terms of the correlation between recurrence and operative methods, and risk, the hazard risk (HR) was measured at 0.552 (0.267-5.343), indicating that there was no close correlation. Conclusion: Laparoscopic surgery is not inferior to laparotomy for advanced ovarian cancer and it is therefore anticipated that laparoscopic surgery can be considered a treatment for early stage and unidentified stage ovarian cancer with low HE 4 and CA 125.

Ovarian cancer; Laparotomy; Laparoscopy; Cancer staging

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