Laparoscopic surgery in early ovarian cancer treatment: safety and efficacy

• Shevchuk A.S.
• Novikova E.G.
• Andrey D. Kaprin

Abstract

Objective - to evaluate the expediency and efficacy of operative Laparoscopy in the surgical treatment of early ovarian cancer.

Subject and methods. Laparoscopic operations were undertaken in 54 patients aged 19 to 76 years with clinical ovarian cancer in the CLinic of Gynecologic Oncology, P.A. Herzen Moscow Oncology Research Institute, in 2003 to 2015. During the operations, particular emphasis was Laid on the observance of the principles of oncological radicaLity and abLastics; the volume of surgery depended on the extent of a tumor process, the morphoLogicaL characteristics of a tumor, the age of a patient, and her wish to preserve reproductive function. Laparoscopic procedures were conducted in 45 (83,3%) cases to restage (after nonradicaL surgery at gynecoLogicaL hospitaLs). The histoLogicaL pattern of an ovarian tumor corresponded to adenocarcinoma in aLL the 54 patients.

Results. The mean time for surgery was 135±10 min; the mean bLood Loss was 80,2±14,3 mL. A postoperative compLication (bLeeding omentaL vesseLs) was recorded in 1 (1,8%) patient; conversion was needed in 4 (7,4%) cases because of an adhesion process or signs of dissemination. A disease stage increase was stated in 16 (29,6%) cases. The median foLLow-up was 52 months; reLapses occurred in 5 (9,3%) patients. 2 (3,7%) of the 54 patients died from disease progression. The reLapse-free and overaLL survivaL rates were 90,7 and 96,3%, respectiveLy.

Conclusion. The data avaiLabLe in worLd Literature and our investigation suggest that a Laparoscopic approach and a Laparotomic one are potentiaLLy equivaLent in treating earLy ovarian cancer. However, muLticenter randomized studies are needed to obtain objective resuLts.

Keywords:ovarian cancer, laparoscopy, surgical treatment

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