Is laparotomy for staging early ovarian cancer an absolute necessity?

STUDY

OBJECTIVE

To demonstrate that palpation of the omentum, mesentery, and intestine can be omitted from the laparoscopic staging of stage I carcinoma of the ovary.

DESIGN

Retrospective analysis of 223 women with stages III and IV ovarian cancer treated by laparotomy.

SETTING

Gynecological Oncology Clinic, M. Sklodowska-Curie Memorial Cancer Institute of Oncology, Warsaw, Poland.

INTERVENTIONS: Observation of macroscopic spread of tumor to areas accessible to laparoscopic inspection versus spread to areas inaccessible to laparoscopic evaluation.

MEASUREMENTS AND MAIN

RESULTS

Macroscopically detectable disease in the areas easily accessible to laparoscopic inspection was present in all cases of metastases to the mesentery, omentum, or intestine.

CONCLUSION

The diagnosis of FIGO stage I ovarian cancer can be made with confidence if laparoscopic inspection of certain areas reveals no evidence of metastases.