Laparoscopy versus laparotomy for FIGO stage I ovarian cancer
Editorial Group: Cochrane Gynaecological Cancer Group
Published Online: 28 FEB 2013
Assessed as up-to-date: 23 NOV 2012
Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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.
- Publication Status: Edited (no change to conclusions)
- Published Online: 28 FEB 2013
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.
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).
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.
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.
We performed no meta-analyses.
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
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.