Objective
We sought to perform a quantitative analysis on operative outcomes of laparoscopic
staging surgery in patients with presumed early-stage ovarian cancer using a metaanalysis.
Study Design
Electronic searches for studies of laparoscopic staging surgery in patients with ovarian
cancer were performed within 3 electronic databases (Medline, Embase, and the Cochrane
Library) using the key words "ovarian cancer,” “early stage,” "laparoscopy,” "staging
surgery,” “staging laparoscopy,” and “recurrence.” Two authors independently screened
articles, and those meeting the defined inclusion/exclusion criteria were included
in the metaanalysis.
Results
We identified 11 observational studies. The combined results of 3 retrospective studies
showed that the estimated blood loss in laparoscopy was significantly lower than that
for laparotomy (P < .001). The overall upstaging rate after laparoscopic surgery was 22.6% (95% confidence
interval [CI], 18.1–27.9%) without significant heterogeneity among all study results.
The overall incidence of conversion from laparoscopy to laparotomy was 3.7% (95% CI,
2.0–6.9%). The overall rate of recurrence in studies with a median follow-up period
of ≥19 months was 9.9% (95% CI, 6.7–14.4%).
Conclusion
Through our quantitative analysis, we concluded that the operative outcomes of a laparoscopic
approach in patients with early-stage ovarian cancer could be compatible with those
of laparotomy. In the future, further randomized controlled trials may be needed.
Key words
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Article Info
Publication History
Published online: April 12, 2013
Accepted:
April 4,
2013
Received in revised form:
February 28,
2013
Received:
December 23,
2012
Footnotes
Supported by the Brain Korea 21 Project for Medical Sciences, Yonsei University , and by grant number A084120 from the Korea Healthcare Technology Research and Development Project, Ministry for Health, Welfare, and Family Affairs, Republic of Korea .
The authors report no conflict of interest.
Cite this article as: Park HJ, Kim DW, Yim GW, et al. Staging laparoscopy for the management of early-stage ovarian cancer: a metaanalysis. Am J Obstet Gynecol 2013;209:58.e1-8.
Identification
Copyright
© 2013 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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- ReplyAmerican Journal of Obstetrics & GynecologyVol. 209Issue 6
- Staging laparoscopy for the management of early-stage ovarian cancer: a metaanalysisAmerican Journal of Obstetrics & GynecologyVol. 209Issue 6
- PreviewWith interest we read the recently published article by Park et al,1 who reported the results of a metaanalysis of surgical outcomes in patients with apparent early-stage ovarian cancer that was staged by laparoscopy. Well-known advantages of the laparoscopic approach (eg, reduced blood loss) were confirmed, and it was stated that “the operative outcomes of a laparoscopic approach in patients with epithelial ovarian cancer could be compatible with those of laparotomy.” Despite the fact that the advantages of laparoscopy are of great benefit for patients with benign diseases and in selected patients with endometrial cancer and cervical cancer, its merit in early ovarian cancer is debatable.
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