Clinical comparative analysis of comprehensive laparoscopic and laparotomic staging of early-stage epithelial ovarian cancer

Abstract

Objective: To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods: A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results: (1) LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion (14% vs 58%) , larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5±4.6), lower vasual analogue scalescore (VAS) pain score (2.1±1.6 vs 3.0±1.1), shorter gastrointestinal recovery time [(2.6±0.8) vs (3.5±0.9) days] and shorter hospital stay [(9.9±2.9) vs (11.3±5.0) days] when compared with LPT group (all P<0.01). No significant difference were found in operation time, number of para-aortic lymph nodes, rate of postoperative upstaging and adjuvant chemotherapy between the two groups (all P>0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19% (6/31), χ(2)=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ(2)=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874) . Conclusion: Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.