Laparoscopic Versus Laparotomic Surgical Staging for Early-Stage Ovarian Cancer: A Case-Control Study

Valerio Gallotta, Marco Petrillo, Carmine Conte, Giuseppe Vizzielli, Anna Fagotti, Gabriella Ferrandina, Francesco Fanfani, Barbara Costantini, Vittoria Carbone, Giovanni Scambia

Research output: Contribution to journalArticle

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Abstract

Study Objective: To evaluate the oncologic outcomes of patients with early-stage ovarian cancer (eOC) managed by laparoscopy or laparotomy in a single high-volume gynecologic cancer center. Design: Retrospective case-control study (Canadian Task Force classification II-2). Setting: Catholic University of the Sacred Hearth, Rome, Italy. Patients: Data of consecutive women with eOC undergoing comprehensive laparoscopic staging between 2007 and 2013 were matched with a cohort of patients undergoing open surgery between 2000 and 2011. Four-year survival outcomes were analyzed using the Kaplan-Meier method. Measurements and Results: Sixty women undergoing staging via laparoscopy were compared with a cohort of 120 patients undergoing open surgery. Baseline characteristics were similar between groups. Seventy percent of patients underwent adjuvant platinum based chemotherapy without differences between the 2 groups. Operative time (p = .01), estimated blood loss (p = .032), and median hospital stay (p = .001) were higher in patients submitted to laparotomic versus laparoscopic staging. As of October 2015, median duration of follow-up was 38 months (range, 24 -48), recurrent disease was documented in 16 patients (13.3%) in the laparotomic group and in 5 patients (8.3%) in the laparoscopic group (p = .651), without differences in the pattern of recurrence presentation. Four-year progression-free survival (PFS) and overall survival (OS) rates were 89% and 92% in the laparoscopic group, respectively, and 81% and 91% in the laparotomic group, without any statistical significant difference between the groups (4-year PFS p = .651; 4-year OS p = .719). Conclusion: The findings of the present study suggests that in the surgical treatment of FIGO stage I ovarian cancer, laparoscopy is associated with equivalent oncologic outcome compared with a conventional abdominal approach.

Original languageEnglish
JournalJournal of Minimally Invasive Gynecology
DOIs
Publication statusAccepted/In press - Feb 16 2016

Fingerprint

Ovarian Neoplasms
Case-Control Studies
Laparoscopy
Disease-Free Survival
Survival
Advisory Committees
Operative Time
Platinum
Laparotomy
Italy
Length of Stay
Survival Rate
Recurrence
Drug Therapy
Neoplasms

Keywords

  • Early ovarian cancer
  • Laparoscopy
  • Ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Gallotta, V., Petrillo, M., Conte, C., Vizzielli, G., Fagotti, A., Ferrandina, G., ... Scambia, G. (Accepted/In press). Laparoscopic Versus Laparotomic Surgical Staging for Early-Stage Ovarian Cancer: A Case-Control Study. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2016.03.006

Laparoscopic Versus Laparotomic Surgical Staging for Early-Stage Ovarian Cancer : A Case-Control Study. / Gallotta, Valerio; Petrillo, Marco; Conte, Carmine; Vizzielli, Giuseppe; Fagotti, Anna; Ferrandina, Gabriella; Fanfani, Francesco; Costantini, Barbara; Carbone, Vittoria; Scambia, Giovanni.

In: Journal of Minimally Invasive Gynecology, 16.02.2016.

Research output: Contribution to journalArticle

Gallotta, V, Petrillo, M, Conte, C, Vizzielli, G, Fagotti, A, Ferrandina, G, Fanfani, F, Costantini, B, Carbone, V & Scambia, G 2016, 'Laparoscopic Versus Laparotomic Surgical Staging for Early-Stage Ovarian Cancer: A Case-Control Study', Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2016.03.006
Gallotta, Valerio ; Petrillo, Marco ; Conte, Carmine ; Vizzielli, Giuseppe ; Fagotti, Anna ; Ferrandina, Gabriella ; Fanfani, Francesco ; Costantini, Barbara ; Carbone, Vittoria ; Scambia, Giovanni. / Laparoscopic Versus Laparotomic Surgical Staging for Early-Stage Ovarian Cancer : A Case-Control Study. In: Journal of Minimally Invasive Gynecology. 2016.
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abstract = "Study Objective: To evaluate the oncologic outcomes of patients with early-stage ovarian cancer (eOC) managed by laparoscopy or laparotomy in a single high-volume gynecologic cancer center. Design: Retrospective case-control study (Canadian Task Force classification II-2). Setting: Catholic University of the Sacred Hearth, Rome, Italy. Patients: Data of consecutive women with eOC undergoing comprehensive laparoscopic staging between 2007 and 2013 were matched with a cohort of patients undergoing open surgery between 2000 and 2011. Four-year survival outcomes were analyzed using the Kaplan-Meier method. Measurements and Results: Sixty women undergoing staging via laparoscopy were compared with a cohort of 120 patients undergoing open surgery. Baseline characteristics were similar between groups. Seventy percent of patients underwent adjuvant platinum based chemotherapy without differences between the 2 groups. Operative time (p = .01), estimated blood loss (p = .032), and median hospital stay (p = .001) were higher in patients submitted to laparotomic versus laparoscopic staging. As of October 2015, median duration of follow-up was 38 months (range, 24 -48), recurrent disease was documented in 16 patients (13.3{\%}) in the laparotomic group and in 5 patients (8.3{\%}) in the laparoscopic group (p = .651), without differences in the pattern of recurrence presentation. Four-year progression-free survival (PFS) and overall survival (OS) rates were 89{\%} and 92{\%} in the laparoscopic group, respectively, and 81{\%} and 91{\%} in the laparotomic group, without any statistical significant difference between the groups (4-year PFS p = .651; 4-year OS p = .719). Conclusion: The findings of the present study suggests that in the surgical treatment of FIGO stage I ovarian cancer, laparoscopy is associated with equivalent oncologic outcome compared with a conventional abdominal approach.",
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AU - Vizzielli, Giuseppe

AU - Fagotti, Anna

AU - Ferrandina, Gabriella

AU - Fanfani, Francesco

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