Single-Site Laparoscopic Comprehensive Staging Of Early Ovarian Cancer

Abstract

Study Objective To review the single-site laparoscopic staging procedure in a series of patients with early ovarian cancer and compare results with the literature. Design A prospective single-center study. Setting A hospital in China. Patients or Participants A total of 21 patients with apparent early stage ovarian cancer from January 2017 through March 2019. The histologic tumor types were epithelial tumors (18 patients) and dysgerminoma (2 patients). All the epithelial tumors were invasive (13 serous and 8 mucinous). Interventions Single-site laparoscopic comprehensive staging was performed in all patients according to the International Federation of Gynecology and Obstetrics guidelines. Measurements and Main Results Fifteen patients had previous adnexal surgery and diagnosis and surgical staging were performed in only 6 patients during the same surgery. The patients’ median age was 32.8 years (range 26–57). Four (19%) patients desired to maintain fertility and a conservative approach was performed for this group. Single-site laparoscopic staging was completed in 20 (95%) patients. In 1 case, a conversion to laparoscopic was necessary as the para-aortic lymphadenectomy was completed because of a vessel injury that was repaired without difficulty. The median operative timewas 265 minutes (range 210–320) for radical surgery and 218 minutes (range 120–240) for the conservative approach. The mean hospital stay was 3 days. Of the 21 total patients, 6 (28.6%) were upstaged. The median follow-up was 24.7 months (range 1–27), with a disease-free survival of 100% and an overall survival of 100%. No recurrence was observed. Conclusion A comprehensive surgical staging procedure is clearly indicated in cases of early ovarian cancer and oncologic guidelines should be respected. The Single-site laparoscopic approach could be a valid alternative to laparoscopic or laparotomy.