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Comparison of Laparoscopy and Laparotomy in Surgical Staging of Early-Stage Ovarian and Fallopian Tubal Cancer

Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, #388-1 Poongnap-2 dong, Songpagu, Seoul 138-736, Korea

Correspondence: Address correspondence and reprint requests to: Joo-Hyun Nam, MD, PhD; E-mail: jhnam{at}amc.seoul.kr

Aim: To compare feasibility, accuracy, and safety of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer.

Methods: Outcomes of patients with stage I ovarian and fallopian tubal cancer who underwent complete surgical staging at Asan Medical Center, Korea between 2004 and 2007 were retrospectively evaluated.

Results: Nineteen patients were surgically staged through laparoscopy and 33 through laparotomy. There were no between-group differences in mean age, parity, body mass index, lymph nodes retrieved, or omentum specimen size, nor were there between-group differences in the percentage of patients who were postmenopausal, those referred for restaging, in the time interval to restaging, in those upstaged after surgery, or in those with intraoperative tumor rupture. The laparoscopy group had significantly shorter operating time (221 ± 83 min versus 275 ± 63 min, P = 0.012), less blood loss (240 ± 228 mL versus 568 ± 451 mL, P = 0.005), less transfusion requirement (5.3% versus 30.3%, P = 0.033), faster return of bowel movement (1.3 ± 0.7 days versus 3.6 ± 1.7 days. P < 0.001), and shorter postoperative hospital stay (8.9 ± 6.1 days versus 14.5 ± 5.6 days, P = 0.002) and time interval to adjuvant chemotherapy (12.8 ± 4.9 days versus 17.6 ± 8.3 days, P = 0.049). There were no postoperative complications requiring further management. After a median follow-up time of 17 months (range 1–44 months), there was no recurrence or death from disease in either group.

Conclusion: Laparotomy and laparoscopy showed similar surgical staging adequacy and accuracy, and laparoscopy showed more favorable operative outcomes. Laparoscopy was safe for early-stage ovarian and fallopian tubal cancer, although follow-up time was relatively short.

Key Words: Laparoscopic surgical staging • Ovarian cancer • Fallopian tubal cancer