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Laparoscopy versus laparotomy for FIGO stage I ovarian cancer

  1. Theresa A Lawrie1,
  2. Lídia RF Medeiros2,
  3. Daniela D Rosa3,*,
  4. Maria Ines da Rosa4,
  5. Maria I Edelweiss5,
  6. Airton T Stein6,
  7. Alice Zelmanowicz7,
  8. Anaelena B Moraes8,
  9. Roselaine R Zanini8

Editorial Group: Cochrane Gynaecological Cancer Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 23 NOV 2012

DOI: 10.1002/14651858.CD005344.pub3


How to Cite

Lawrie TA, Medeiros LRF, Rosa DD, da Rosa MI, Edelweiss MI, Stein AT, Zelmanowicz A, Moraes AB, Zanini RR. Laparoscopy versus laparotomy for FIGO stage I ovarian cancer. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD005344. DOI: 10.1002/14651858.CD005344.pub3.

Author Information

  1. 1

    Royal United Hospital, Cochrane Gynaecological Cancer Group, Bath, UK

  2. 2

    Post-graduation Program in Medical Sciences, Universidade Federal do Rio Grande do Sul, Social Medicine/Epidemiology, Porto Alegre, Rio Grande do Sul, Brazil

  3. 3

    Hospital Moinhos de Vento, Oncology Unit, Porto Alegre, Rio Grande do Sul, Brazil

  4. 4

    Universidade do Extremo Sul Catarinense, Medical School, Criciuma, Santa Catarina, Brazil

  5. 5

    Faculty of Medicine at Federal University of Rio Grande do Sul, Pathology, Rio Grande do Sul, Brazil

  6. 6

    Universidade Federal de Ciências da Saúde, Department of Public Health, Porto Alegre, Brazil

  7. 7

    Complexo Hospitalar Santa Casa, Cancer Prevention Centre, Rio Grande do Sul, Brazil

  8. 8

    Federal University of Rio Grande do Sul, Postgraduate Program in Epidemiology, Rio Grande do Sul, Brazil

*Daniela D Rosa, Oncology Unit, Hospital Moinhos de Vento, Rua Tiradentes 333, 2nd floor, Porto Alegre, Rio Grande do Sul, 90560-030, Brazil. dornellesrosa@hotmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 28 FEB 2013

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

This is an updated version of the original review that was first published in the Cochrane Database of Systematic Reviews 2008, Issue 4. Laparoscopy has become an increasingly common approach to surgical staging of apparent early-stage ovarian tumours. This review was undertaken to assess the available evidence on the benefits and risks of laparoscopy compared with laparotomy for the management of International Federation of Gynaecology and Obstetrics (FIGO) stage I ovarian cancer.

Objectives

To evaluate the benefits and risks of laparoscopy compared with laparotomy for the surgical treatment of FIGO stage I ovarian cancer (stages Ia, Ib and Ic).

Search methods

For the original review, we searched the Cochrane Gynaecological Cancer Group Trials (CGCRG) Register, Cochrane Central Register of Controlled Trials (CENTRAL 2007, Issue 2), MEDLINE, EMBASE, LILACS, Biological Abstracts and CancerLit from 1 January 1990 to 30 November 2007. We also handsearched relevant journals, reference lists of identified studies and conference abstracts. For this updated review, we extended the CGCRG Specialised Register, CENTRAL, MEDLINE, EMBASE and LILACS searches to 6 December 2011.

Selection criteria

Randomised controlled trials (RCTs), quasi-RCTs and prospective case-control studies comparing laparoscopic staging with open surgery (laparotomy) in women with stage I ovarian cancer according to FIGO.

Data collection and analysis

There were no studies to include, therefore we tabulated data from non-randomised studies (NRS) for discussion.

Main results

We performed no meta-analyses.

Authors' conclusions

This review has found no good-quality evidence to help quantify the risks and benefits of laparoscopy for the management of early-stage ovarian cancer as routine clinical practice.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Laparoscopy versus laparotomy (open surgery) for early-stage ovarian cancer

Stage I ovarian cancer is diagnosed when the tumour is confined to one or both ovaries, without spread to lymph nodes or other parts of the body. Approximately 25% of women with ovarian cancer will be diagnosed at an early stage, thus the diagnosis often occurs due to an accidental finding. The intention of surgical staging is to establish a diagnosis, to assess the extent of the cancer and to remove as much tumour as possible. The latter is particularly important as women with ovarian cancer survive for longer when all visible tumour has been removed.

We conducted this review in an attempt to clarify whether laparoscopy (keyhole surgery) is as safe and effective as laparotomy (open surgery) for early-stage ovarian cancer. We intended to include only high-quality studies that compared the two types of surgery.

We wanted to know whether women having laparoscopy survived as long as those having open surgery and whether there were differences in the time it took for the cancer to get worse. We were also interested to see how these different surgeries compared with regard to blood loss and other complications.

Unfortunately, we were unable to find any high-quality randomised trials comparing these approaches. Further research is needed.