Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000020.xml
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2022; 82(12): 1368-1377
DOI: 10.1055/a-1787-9144
DOI: 10.1055/a-1787-9144
GebFra Science
Review
Laparoscopic Surgery for Ovarian Neoplasms – What is Possible, What is Useful?
Article in several languages: English | deutsch
Abstract
The use of minimally invasive surgical techniques is becoming increasingly important in gynecologic oncology due to technical advances and the increasing level of surgical expertise. In addition to laparoscopic approaches for the treatment of benign neoplasms, minimally invasive surgical methods have also become established in some areas for treating gynecologic malignancies. For tumor entities such as endometrial and cervical carcinoma, there are conclusive studies emphasizing the role of laparoscopy in surgical therapy. By contrast, due to a lack of prospective data with survival analyses, no clear conclusions can be drawn on the significance of laparoscopy in the surgical treatment of ovarian carcinoma. However, some smaller, mostly retrospective case–control studies and cohort studies open the way for a discussion, positing the possibility that laparoscopic surgical procedures, particularly for early ovarian carcinoma, are technically feasible and of a quality equivalent to that of conventional longitudinal laparotomy, and may also be associated with lower perioperative morbidity.
In this article we discuss the most important aspects of using minimally invasive surgical techniques for ovarian carcinoma based on the current literature. In particular we look at the relevance of laparoscopy as a primary approach for surgical staging of early ovarian carcinoma, and we evaluate the role of diagnostic laparoscopy in assessing the operability of advanced ovarian carcinoma.
Publication History
Received: 27 June 2022
Accepted after revision: 21 October 2022
Article published online:
01 December 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References/Literatur
- 1 Wagner U, Reuß A. S3-Leitlinie „Diagnostik, Therapie und Nachsorge maligner Ovarialtumoren“: Leitlinienprogramm Onkologie, Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF: Langversion 3.0, 2019, AWMF-Registernummer: 032/035OL. Forum 2019; 34: 413-415
- 2 Colomer AT, Jiménez AM, Bover Barceló MI. Laparoscopic treatment and staging of early ovarian cancer. J Minim Invasive Gynecol 2008; 15: 414-419
- 3 Nezhat FR, Ezzati M, Chuang L. et al. Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome. Am J Obstet Gynecol 2009; 200: 83.e1-83.e6
- 4 Pomel C, Provencher D, Dauplat J. et al. Laparoscopic staging of early ovarian cancer. Gynecol Oncol 1995; 58: 301-306
- 5 Chi DS, Abu-Rustum NR, Sonoda Y. et al. The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers. Am J Obstet Gynecol 2005; 192: 1614-1619
- 6 Lawrie TA, Medeiros LRF, Rosa DD. et al. Laparoscopy versus laparotomy for FIGO stage I ovarian cancer. Cochrane Database Syst Rev 2013; (02) CD005344
- 7 Borgfeldt C, Andolf E. Transvaginal sonographic ovarian findings in a random sample of women 25–40 years old. Ultrasound Obstet Gynecol 1999; 13: 345-350
- 8 Padilla LA, Radosevich DM, Milad MP. Accuracy of the pelvic examination in detecting adnexal masses. Obstet Gynecol 2000; 96: 593-598
- 9 Wolf SI, Gosink BB, Feldesman MR. et al. Prevalence of simple adnexal cysts in postmenopausal women. Radiology 1991; 180: 65-71
- 10 Park JY, Kim DY, Suh DS. et al. Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer. Ann Surg Oncol 2008; 15: 2012-2019
- 11 Pados G, Tsolakidis D, Bontis J. Laparoscopic management of the adnexal mass. Ann N Y Acad Sci 2006; 1092: 211-228
- 12 Leng J, Lang J, Zhang J. et al. Role of laparoscopy in the diagnosis and treatment of adnexal masses. Chin Med J (Engl) 2006; 119: 202-206
- 13 Lee JW, Kim CJ, Lee JE. et al. Selected adnexal cystic masses in postmenopausal women can be safely managed by laparoscopy. J Korean Med Sci 2005; 20: 468-472
- 14 Nezhat F, Nezhat C, Welander CE. et al. Four ovarian cancers diagnosed during laparoscopic management of 1011 women with adnexal masses. Am J Obstet Gynecol 1992; 167: 790-796
- 15 Mecke H, Lehmann-Willenbrock E, Ibrahim M. et al. Pelviscopic treatment of ovarian cysts in premenopausal women. Gynecol Obstet Invest 1992; 34: 36-42
- 16 Fishman DA, Cohen L, Blank SV. et al. The role of ultrasound evaluation in the detection of early-stage epithelial ovarian cancer. Am J Obstet Gynecol 2005; 192: 1214-1221
- 17 Wenzl R, Lehner R, Husslein P. et al. Laparoscopic surgery in cases of ovarian malignancies: an Austria-wide survey. Gynecol Oncol 1996; 63: 57-61
- 18 Muzii L, Angioli R, Zullo M. et al. The unexpected ovarian malignancy found during operative laparoscopy: incidence, management, and implications for prognosis. J Minim Invasive Gynecol 2005; 12: 81-89
- 19 Nohuz E, De Simone L, Chêne G. Reliability of IOTA score and ADNEX model in the screening of ovarian malignancy in postmenopausal women. J Gynecol Obstet Hum Reprod 2019; 48: 103-107
- 20 Van Calster B, Van Hoorde K, Valentin L. et al. Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study. BMJ 2014; 349: g5920
- 21 Araujo KG, Jales RM, Pereira PN. et al. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center. Ultrasound Obstet Gynecol 2017; 49: 778-783
- 22 Szubert S, Wojtowicz A, Moszynski R. et al. External validation of the IOTA ADNEX model performed by two independent gynecologic centers. Gynecol Oncol 2016; 142: 490-495
- 23 Gad MS, El Khouly NI, Soto E. et al. Differences in perioperative outcomes after laparoscopic management of benign and malignant adnexal masses. J Gynecol Oncol 2011; 22: 18-24
- 24 Canis M, Pouly JL, Wattiez A. et al. Laparoscopic management of adnexal masses suspicious at ultrasound. Obstet Gynecol 1997; 89: 679-683
- 25 Biran G, Golan A, Sagiv R. et al. Conversion of laparoscopy to laparotomy due to adnexal malignancy. Eur J Gynaecol Oncol 2002; 23: 157-160
- 26 Dottino PR, Levine DA, Ripley DL. et al. Laparoscopic management of adnexal masses in premenopausal and postmenopausal women. Obstet Gynecol 1999; 93: 223-228
- 27 Stier EA, Barakat RR, Curtin JP. et al. Laparotomy to complete staging of presumed early ovarian cancer. Obstet Gynecol 1996; 87: 737-740
- 28 Soper JT, Johnson P, Johnson V. et al. Comprehensive restaging laparotomy in women with apparent early ovarian carcinoma. Obstet Gynecol 1992; 80: 949-953
- 29 Young RC, Decker DG, Wharton JT. et al. Staging laparotomy in early ovarian cancer. JAMA 1983; 250: 3072-3076
- 30 Grabowski JP, Harter P, Buhrmann C. et al. Re-operation outcome in patients referred to a gynecologic oncology center with presumed ovarian cancer FIGO I-IIIA after sub-standard initial surgery. Surg Oncol 2012; 21: 31-35
- 31 Trimbos JB, Vergote I, Bolis G. et al. Impact of adjuvant chemotherapy and surgical staging in early-stage ovarian carcinoma: European Organisation for Research and Treatment of Cancer-Adjuvant ChemoTherapy in Ovarian Neoplasm trial. J Natl Cancer Inst 2003; 95: 113-125
- 32 Trimbos B, Timmers P, Pecorelli S. et al. Surgical staging and treatment of early ovarian cancer: long-term analysis from a randomized trial. J Natl Cancer Inst 2010; 102: 982-987
- 33 du Bois A, Rochon J, Pfisterer J. et al. Variations in institutional infrastructure, physician specialization and experience, and outcome in ovarian cancer: a systematic review. Gynecol Oncol 2009; 112: 422-436
- 34 Rosenoff SH, Young RC, Anderson T. et al. Peritoneoscopy: a valuable staging tool in ovarian carcinoma. Ann Intern Med 1975; 83: 37-41
- 35 Spinelli P, Luini A, Pizzetti P. et al. Laparoscopy in staging and restaging of 95 patients with ovarian carcinoma. Tumori 1976; 62: 493-501
- 36 Medeiros LRF, Rosa DD, Bozzetti MC. et al. Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer. Cochrane Database Syst Rev 2008; (04) CD005344
- 37 Conrad LB, Ramirez PT, Burke W. et al. Role of Minimally Invasive Surgery in Gynecologic Oncology: An Updated Survey of Members of the Society of Gynecologic Oncology. Int J Gynecol Cancer 2015; 25: 1121-1127
- 38 Matsuo K, Chang EJ, Matsuzaki S. et al. Minimally invasive surgery for early-stage ovarian cancer: Association between hospital surgical volume and short-term perioperative outcomes. Gynecol Oncol 2020; 158: 59-65
- 39 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.e1-58.e8
- 40 Ghezzi F, Cromi A, Uccella S. et al. Laparoscopy versus laparotomy for the surgical management of apparent early stage ovarian cancer. Gynecol Oncol 2007; 105: 409-413
- 41 Park JY, Bae J, Lim MC. et al. Laparoscopic and laparotomic staging in stage I epithelial ovarian cancer: a comparison of feasibility and safety. Int J Gynecol Cancer 2008; 18: 1202-1209
- 42 Weber S, McCann CK, Boruta DM. et al. Laparoscopic Surgical Staging of Early Ovarian Cancer. Rev Obstet Gynecol 2011; 4: 117-122
- 43 Hua K, Jin F, Xu H. et al. Evaluation of laparoscopic surgery in the early stage-malignant tumor of ovary with lower risk. Zhonghua Yi Xue Za Zhi 2005; 85: 169-172
- 44 Minig L, Saadi J, Patrono MG. et al. Laparoscopic surgical staging in women with early stage epithelial ovarian cancer performed by recently certified gynecologic oncologists. Eur J Obstet Gynecol Reprod Biol 2016; 201: 94-100
- 45 Matsuo K, Huang Y, Matsuzaki S. et al. Minimally Invasive Surgery and Risk of Capsule Rupture for Women With Early-Stage Ovarian Cancer. JAMA Oncol 2020; 6: 1110-1113
- 46 Matsuo K, Machida H, Yamagami W. et al. Intraoperative Capsule Rupture, Postoperative Chemotherapy, and Survival of Women With Stage I Epithelial Ovarian Cancer. Obstet Gynecol 2019; 134: 1017-1026
- 47 Kim HS, Ahn JH, Chung HH. et al. Impact of intraoperative rupture of the ovarian capsule on prognosis in patients with early-stage epithelial ovarian cancer: a meta-analysis. Eur J Surg Oncol 2013; 39: 279-289
- 48 Vergote I, De Brabanter J, Fyles A. et al. Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet 2001; 357: 176-182
- 49 Ataseven B, Grimm C, Harter P. et al. Prognostic impact of debulking surgery and residual tumor in patients with epithelial ovarian cancer FIGO stage IV. Gynecol Oncol 2016; 140: 215-220
- 50 Sjövall K, Nilsson B, Einhorn N. Different types of rupture of the tumor capsule and the impact on survival in early ovarian carcinoma. Int J Gynecol Cancer 1994; 4: 333-336
- 51 Gal D, Lind L, Lovecchio JL. et al. Comparative study of laparoscopy vs. laparotomy for adnexal surgery: efficacy, safety, and cyst rupture. J Gynecol Surg 1995; 11: 153-158
- 52 Tozzi R, Köhler C, Ferrara A. et al. Laparoscopic treatment of early ovarian cancer: surgical and survival outcomes. Gynecol Oncol 2004; 93: 199-203
- 53 Lee M, Kim SW, Paek J. et al. Comparisons of surgical outcomes, complications, and costs between laparotomy and laparoscopy in early-stage ovarian cancer. Int J Gynecol Cancer 2011; 21: 251-256
- 54 Smidt VJ, Singh DM, Hurteau JA. et al. Effect of carbon dioxide on human ovarian carcinoma cell growth. Am J Obstet Gynecol 2001; 185: 1314-1317
- 55 Dorrance HR, Oien K, O’Dwyer PJ. Effects of laparoscopy on intraperitoneal tumor growth and distant metastases in an animal model. Surgery 1999; 126: 35-40
- 56 Bergström M, Falk P, Park P-O. et al. Peritoneal and systemic pH during pneumoperitoneum with CO2 and helium in a pig model. Surg Endosc 2008; 22: 359-364
- 57 Greene FL. Principles of Cancer Biology in Relation to Minimal Access Surgical Techniques. Semin Laparosc Surg 1995; 2: 155-157
- 58 Volz J, Köster S, Spacek Z. et al. The influence of pneumoperitoneum used in laparoscopic surgery on an intraabdominal tumor growth. Cancer 1999; 86: 770-774
- 59 Abu-Rustum NR, Sonoda Y, Chi DS. et al. The effects of CO2 pneumoperitoneum on the survival of women with persistent metastatic ovarian cancer. Gynecol Oncol 2003; 90: 431-434
- 60 Liu CS, Nagarsheth NP, Nezhat FR. Laparoscopy and ovarian cancer: a paradigm change in the management of ovarian cancer?. J Minim Invasive Gynecol 2009; 16: 250-262
- 61 Ramirez PT, Wolf JK, Levenback C. Laparoscopic port-site metastases: etiology and prevention. Gynecol Oncol 2003; 91: 179-189
- 62 Nagarsheth NP, Rahaman J, Cohen CJ. et al. The incidence of port-site metastases in gynecologic cancers. JSLS 2004; 8: 133-139
- 63 Morice P, Camatte S, Larregain-Fournier D. et al. Port-site implantation after laparoscopic treatment of borderline ovarian tumors. Obstet Gynecol 2004; 104: 1167-1170
- 64 Heitz F, Ognjenovic D, Harter P. et al. Abdominal wall metastases in patients with ovarian cancer after laparoscopic surgery: incidence, risk factors, and complications. Int J Gynecol Cancer 2010; 20: 41-46
- 65 Knisely A, Gamble CR, St Clair CM. et al. The Role of Minimally Invasive Surgery in the Care of Women with Ovarian Cancer: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol 2021; 28: 537-543
- 66 du Bois A, Reuss A, Pujade-Lauraine E. et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe d’Investigateurs Nationaux Pour les Etudes des Cancers de l’Ovaire (GINECO). Cancer 2009; 115: 1234-1244
- 67 Bristow RE, Tomacruz RS, Armstrong DK. et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20: 1248-1259
- 68 Chang S-J, Hodeib M, Chang J. et al. Survival impact of complete cytoreduction to no gross residual disease for advanced-stage ovarian cancer: a meta-analysis. Gynecol Oncol 2013; 130: 493-498
- 69 Harter P, Sehouli J, Lorusso D. et al. A Randomized Trial of Lymphadenectomy in Patients with Advanced Ovarian Neoplasms. N Engl J Med 2019; 380: 822-832
- 70 Vergote I, Tropé CG, Amant F. et al. Neoadjuvant Chemotherapy or Primary Surgery in Stage IIIC or IV Ovarian Cancer. N Engl J Med 2010; 363: 943-953
- 71 van der Burg ME, van Lent M, Buyse M. et al. The effect of debulking surgery after induction chemotherapy on the prognosis in advanced epithelial ovarian cancer. Gynecological Cancer Cooperative Group of the European Organization for Research and Treatment of Cancer. N Engl J Med 1995; 332: 629-634
- 72 Rose PG, Nerenstone S, Brady MF. et al. Secondary surgical cytoreduction for advanced ovarian carcinoma. N Engl J Med 2004; 351: 2489-2497
- 73 Anic K, Birkert S, Schmidt MW. et al. G-8 Geriatric Screening Tool Independently Predicts Progression-Free Survival in Older Ovarian Cancer Patients Irrespective of Maximal Surgical Effort: Results of a Retrospective Cohort Study. Gerontology 2022; 68: 1101-1110
- 74 Anic K, Schmidt MW, Schmidt M. et al. Impact of perioperative red blood cell transfusion, anemia of cancer and global health status on the prognosis of elderly patients with endometrial and ovarian cancer. Front Oncol 2022; 12: 967421
- 75 Wright AA, Bohlke K, Armstrong DK. et al. Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol 2016; 34: 3460-3473
- 76 Kang S, Nam BH. Does neoadjuvant chemotherapy increase optimal cytoreduction rate in advanced ovarian cancer? Meta-analysis of 21 studies. Ann Surg Oncol 2009; 16: 2315-2320
- 77 Kehoe S, Hook J, Nankivell M. et al. Primary chemotherapy versus primary surgery for newly diagnosed advanced ovarian cancer (CHORUS): an open-label, randomised, controlled, non-inferiority trial. Lancet 2015; 386: 249-257
- 78 Greimel E, Kristensen GB, van der Burg MEL. et al. Quality of life of advanced ovarian cancer patients in the randomized phase III study comparing primary debulking surgery versus neo-adjuvant chemotherapy. Gynecol Oncol 2013; 131: 437-444
- 79 Vergote I, Coens C, Nankivell M. et al. Neoadjuvant chemotherapy versus debulking surgery in advanced tubo-ovarian cancers: pooled analysis of individual patient data from the EORTC 55971 and CHORUS trials. Lancet Oncol 2018; 19: 1680-1687
- 80 Fagotti A, Fanfani F, Ludovisi M. et al. Role of laparoscopy to assess the chance of optimal cytoreductive surgery in advanced ovarian cancer: a pilot study. Gynecol Oncol 2005; 96: 729-735
- 81 Angioli R, Palaia I, Zullo MA. et al. Diagnostic open laparoscopy in the management of advanced ovarian cancer. Gynecol Oncol 2006; 100: 455-461
- 82 Gómez-Hidalgo NR, Martinez-Cannon BA, Nick AM. et al. Predictors of optimal cytoreduction in patients with newly diagnosed advanced-stage epithelial ovarian cancer: time to incorporate laparoscopic assessment into the standard of care. Gynecol Oncol 2015; 137: 553-558
- 83 Rutten MJ, van Meurs HS, van de Vrie R. et al. Laparoscopy to Predict the Result of Primary Cytoreductive Surgery in Patients With Advanced Ovarian Cancer: A Randomized Controlled Trial. J Clin Oncol 2017; 35: 613-621
- 84 Petrillo M, Vizzielli G, Fanfani F. et al. Definition of a dynamic laparoscopic model for the prediction of incomplete cytoreduction in advanced epithelial ovarian cancer: proof of a concept. Gynecol Oncol 2015; 139: 5-9
- 85 Zeff N. Role of laparoscopy in initial tumour staging in advanced epithelial ovarian cancer: A systematic review. Pleura Peritoneum 2018; 3: 20180106
- 86 Ansquer Y, Leblanc E, Clough K. et al. Neoadjuvant chemotherapy for unresectable ovarian carcinoma: a French multicenter study. Cancer 2001; 91: 2329-2334
- 87 Deffieux X, Castaigne D, Pomel C. Role of laparoscopy to evaluate candidates for complete cytoreduction in advanced stages of epithelial ovarian cancer. Int J Gynecol Cancer 2006; 16 (Suppl. 01) 35-40
- 88 Fagotti A, Ferrandina G, Fanfani F. et al. A laparoscopy-based score to predict surgical outcome in patients with advanced ovarian carcinoma: a pilot study. Ann Surg Oncol 2006; 13: 1156-1161
- 89 Brun J-L, Rouzier R, Uzan S. et al. External validation of a laparoscopic-based score to evaluate resectability of advanced ovarian cancers: clues for a simplified score. Gynecol Oncol 2008; 110: 354-359
- 90 Rutten MJ, Leeflang MMG, Kenter GG. et al. Laparoscopy for diagnosing resectability of disease in patients with advanced ovarian cancer. Cochrane Database Syst Rev 2014; (02) CD009786
- 91 Anic K, Altehoefer C, Krajnak S. et al. The preoperative G8 geriatric screening tool independently predicts survival in older patients with endometrial cancer: results of a retrospective single-institution cohort study. J Cancer Res Clin Oncol 2022;
- 92 Armstrong DK, Alvarez RD, Bakkum-Gamez JN. et al. Ovarian Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2021; 19: 191-226
- 93 Ceccaroni M, Roviglione G, Bruni F. et al. Laparoscopy for primary cytoreduction with multivisceral resections in advanced ovarian cancer: prospective validation. „The times they are a-changin“?. Surg Endosc 2018; 32: 2026-2037
- 94 Gueli Alletti S, Capozzi VA, Rosati A. et al. Laparoscopy vs. laparotomy for advanced ovarian cancer: a systematic review of the literature. Minerva Med 2019; 110: 341-357
- 95 Nicoletto MO, Tumolo S, Talamini R. et al. Surgical second look in ovarian cancer: a randomized study in patients with laparoscopic complete remission--a Northeastern Oncology Cooperative Group-Ovarian Cancer Cooperative Group Study. J Clin Oncol 1997; 15: 994-999
- 96 Ott HW, Illmensee K, Zeimet A. et al. The evaluation of the second-look operation of patients with ovarian carcinoma and tubal carcinoma by means of a retrospective comparison study. Gynakol Geburtshilfliche Rundsch 2002; 42: 217-224
- 97 Greer BE, Bundy BN, Ozols RF. et al. Implications of second-look laparotomy in the context of optimally resected stage III ovarian cancer: a non-randomized comparison using an explanatory analysis: a Gynecologic Oncology Group study. Gynecol Oncol 2005; 99: 71-79
- 98 Wu TI, Lee CL, Liao PJ. et al. Survival impact of initial surgical approach in stage I ovarian cancer. Chang Gung Med J 2010; 33: 558-567