Minimally Invasive Surgical Staging for Ovarian Carcinoma: A Propensity-Matched Comparison With Traditional Open Surgery

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Abstract

Study Objective Growing evidence supports the safety of a laparoscopic approach for patients affected by apparent early-stage ovarian cancer. However, no well-designed studies comparing laparoscopic and open surgical staging are available. In the present investigation we aimed to provide a balanced long-term comparison between these 2 approaches. Design Retrospective study (Canadian Task Force classification II-2). Setting Tertiary center. Patients Data of consecutive patients affected by early-stage ovarian cancer who had laparoscopic staging were matched 1:1 with a cohort of patients undergoing open surgical staging. The matching was conducted by a propensity-score comparison. Intervention Laparoscopic and open surgical staging. Measurements and Main Results Fifty patient pairs (100 patients: 50 undergoing laparoscopic staging vs 50 undergoing open surgical staging) were included. Demographic and baseline oncologic characteristics were balanced between groups (p > .2). We observed that patients undergoing laparoscopic staging experienced longer operative time (207.2 [71.6] minutes vs 180.7 [47.0] minutes; p = .04), lower blood loss (150 [52.7] mL vs 339.8 [225.9] mL; p < .001), and shorter length of hospital stay (4.0 [2.6] days vs 6.1 [1.6] days; p < .001) compared with patients undergoing open surgical staging. No conversion to open surgery occurred. Complication rate was similar between groups. No difference in survival outcomes were observed, after a mean (SD) follow-up of 49.5 (64) and 52.6 (31.7) months after laparoscopic and open surgical staging, respectively. Conclusions Our findings suggest that the implementation of minimally invasive staging does not influence survival outcomes of patients affected by early-stage ovarian cancer. Laparoscopic staging improved patient outcomes, reducing length of hospital stay. Further large prospective studies are warranted.

Original languageEnglish
Pages (from-to)98-102
Number of pages5
JournalJournal of Minimally Invasive Gynecology
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Carcinoma
Length of Stay
Ovarian Neoplasms
Conversion to Open Surgery
Propensity Score
Survival
Advisory Committees
Operative Time
Retrospective Studies
Demography
Prospective Studies
Safety

Keywords

  • Laparoscopy
  • Long-term outcomes
  • Open surgery
  • Ovarian cancer
  • Survival

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{faddee428785461b803869b1c0ec58c8,
title = "Minimally Invasive Surgical Staging for Ovarian Carcinoma: A Propensity-Matched Comparison With Traditional Open Surgery",
abstract = "Study Objective Growing evidence supports the safety of a laparoscopic approach for patients affected by apparent early-stage ovarian cancer. However, no well-designed studies comparing laparoscopic and open surgical staging are available. In the present investigation we aimed to provide a balanced long-term comparison between these 2 approaches. Design Retrospective study (Canadian Task Force classification II-2). Setting Tertiary center. Patients Data of consecutive patients affected by early-stage ovarian cancer who had laparoscopic staging were matched 1:1 with a cohort of patients undergoing open surgical staging. The matching was conducted by a propensity-score comparison. Intervention Laparoscopic and open surgical staging. Measurements and Main Results Fifty patient pairs (100 patients: 50 undergoing laparoscopic staging vs 50 undergoing open surgical staging) were included. Demographic and baseline oncologic characteristics were balanced between groups (p > .2). We observed that patients undergoing laparoscopic staging experienced longer operative time (207.2 [71.6] minutes vs 180.7 [47.0] minutes; p = .04), lower blood loss (150 [52.7] mL vs 339.8 [225.9] mL; p < .001), and shorter length of hospital stay (4.0 [2.6] days vs 6.1 [1.6] days; p < .001) compared with patients undergoing open surgical staging. No conversion to open surgery occurred. Complication rate was similar between groups. No difference in survival outcomes were observed, after a mean (SD) follow-up of 49.5 (64) and 52.6 (31.7) months after laparoscopic and open surgical staging, respectively. Conclusions Our findings suggest that the implementation of minimally invasive staging does not influence survival outcomes of patients affected by early-stage ovarian cancer. Laparoscopic staging improved patient outcomes, reducing length of hospital stay. Further large prospective studies are warranted.",
keywords = "Laparoscopy, Long-term outcomes, Open surgery, Ovarian cancer, Survival",
author = "Antonino Ditto and Giorgio Bogani and Fabio Martinelli and Mauro Signorelli and Valentina Chiappa and Cono Scaffa and Alice Indini and {Leone Roberti Maggiore}, Umberto and Domenica Lorusso and Francesco Raspagliesi",
year = "2017",
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day = "1",
doi = "10.1016/j.jmig.2016.09.018",
language = "English",
volume = "24",
pages = "98--102",
journal = "Journal of Minimally Invasive Gynecology",
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TY - JOUR

T1 - Minimally Invasive Surgical Staging for Ovarian Carcinoma

T2 - A Propensity-Matched Comparison With Traditional Open Surgery

AU - Ditto, Antonino

AU - Bogani, Giorgio

AU - Martinelli, Fabio

AU - Signorelli, Mauro

AU - Chiappa, Valentina

AU - Scaffa, Cono

AU - Indini, Alice

AU - Leone Roberti Maggiore, Umberto

AU - Lorusso, Domenica

AU - Raspagliesi, Francesco

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Study Objective Growing evidence supports the safety of a laparoscopic approach for patients affected by apparent early-stage ovarian cancer. However, no well-designed studies comparing laparoscopic and open surgical staging are available. In the present investigation we aimed to provide a balanced long-term comparison between these 2 approaches. Design Retrospective study (Canadian Task Force classification II-2). Setting Tertiary center. Patients Data of consecutive patients affected by early-stage ovarian cancer who had laparoscopic staging were matched 1:1 with a cohort of patients undergoing open surgical staging. The matching was conducted by a propensity-score comparison. Intervention Laparoscopic and open surgical staging. Measurements and Main Results Fifty patient pairs (100 patients: 50 undergoing laparoscopic staging vs 50 undergoing open surgical staging) were included. Demographic and baseline oncologic characteristics were balanced between groups (p > .2). We observed that patients undergoing laparoscopic staging experienced longer operative time (207.2 [71.6] minutes vs 180.7 [47.0] minutes; p = .04), lower blood loss (150 [52.7] mL vs 339.8 [225.9] mL; p < .001), and shorter length of hospital stay (4.0 [2.6] days vs 6.1 [1.6] days; p < .001) compared with patients undergoing open surgical staging. No conversion to open surgery occurred. Complication rate was similar between groups. No difference in survival outcomes were observed, after a mean (SD) follow-up of 49.5 (64) and 52.6 (31.7) months after laparoscopic and open surgical staging, respectively. Conclusions Our findings suggest that the implementation of minimally invasive staging does not influence survival outcomes of patients affected by early-stage ovarian cancer. Laparoscopic staging improved patient outcomes, reducing length of hospital stay. Further large prospective studies are warranted.

AB - Study Objective Growing evidence supports the safety of a laparoscopic approach for patients affected by apparent early-stage ovarian cancer. However, no well-designed studies comparing laparoscopic and open surgical staging are available. In the present investigation we aimed to provide a balanced long-term comparison between these 2 approaches. Design Retrospective study (Canadian Task Force classification II-2). Setting Tertiary center. Patients Data of consecutive patients affected by early-stage ovarian cancer who had laparoscopic staging were matched 1:1 with a cohort of patients undergoing open surgical staging. The matching was conducted by a propensity-score comparison. Intervention Laparoscopic and open surgical staging. Measurements and Main Results Fifty patient pairs (100 patients: 50 undergoing laparoscopic staging vs 50 undergoing open surgical staging) were included. Demographic and baseline oncologic characteristics were balanced between groups (p > .2). We observed that patients undergoing laparoscopic staging experienced longer operative time (207.2 [71.6] minutes vs 180.7 [47.0] minutes; p = .04), lower blood loss (150 [52.7] mL vs 339.8 [225.9] mL; p < .001), and shorter length of hospital stay (4.0 [2.6] days vs 6.1 [1.6] days; p < .001) compared with patients undergoing open surgical staging. No conversion to open surgery occurred. Complication rate was similar between groups. No difference in survival outcomes were observed, after a mean (SD) follow-up of 49.5 (64) and 52.6 (31.7) months after laparoscopic and open surgical staging, respectively. Conclusions Our findings suggest that the implementation of minimally invasive staging does not influence survival outcomes of patients affected by early-stage ovarian cancer. Laparoscopic staging improved patient outcomes, reducing length of hospital stay. Further large prospective studies are warranted.

KW - Laparoscopy

KW - Long-term outcomes

KW - Open surgery

KW - Ovarian cancer

KW - Survival

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