Is laparoscopic approach feasible in early-stage ovarian cancer? A retrospective study in single tertiary center.

Abstract

e17560 Background: Laparoscopic approach for early-stage ovarian cancer is a controversy. Current studies showed no negative impacts on these patients. However, some limitations were noted, such as small case numbers, heterogeneity, and retrospective study. Methods: We retrospectively reviewed our cases who was diagnosed as early-stage ovarian cancer and received staging surgery from 2009 through 2017. There patients were divided into two groups, via laparoscopic staging or laparotomy. The primary outcome was progression-free survival. The secondary outcomes were overall survival and intra-operative rupture rate. We performed the Kaplan-Meier method and chi-square test for analyzing survival outcome and factors, in order to evaluate impacts on different surgical methods. Results: Total 520 patients (2014 FIGO stage IA-IC3) were enrolled, including 355 patients who underwent open surgery and 165 patients who underwent laparoscopic surgery. The median follow-up time for survivors was 71(range,39.7-102.3）months. The progression-free survival was similar between two groups and all subgroups. The overall survival was also similar between two surgical methods and all subgroups, except subgroup of clear cell carcinoma. The p-value of overall survival in clear cell carcinoma patients was 0.05. However, the case numbers of clear cell carcinoma 81 in laparotomy group and 31 in laparoscopy group, respectively. The intra-operative rupture rate was increased in laparoscopic group. The relative risk and p-value were 1.139 and 0.043, respectively. Conclusions: Laparoscopic may be feasible in early-stage ovarian cancer in selected patients and expert surgeon due to higher intra-operative rupture rate. If clear cell carcinoma of ovary was highly suspected, the surgeon should be alerted because poorer overall survival in clear cell carcinoma of ovary patients was observed.