Usefulness of laparoscopic restaging surgery for patients diagnosed with apparent early ovarian/fallopian tubal cancer by a prior surgery, a case control observational study in a single institute in Japan

This study aimed to demonstrate the feasibility, safety, and short-term oncological outcomes of laparoscopic restaging surgery for patients diagnosed with apparent early ovarian/fallopian tubal cancer by a prior surgery in Japan. A total of 22 patients with apparent early stage ovarian/fallopian tubal cancer underwent laparoscopic restaging surgery. Surgical results and oncological outcomes were retrospectively analyzed. The diagnosis of apparent early stage ovarian/fallopian tubal cancer was determined by prior laparoscopic or laparotomic surgery in 15 cases and 7 cases, respectively. The apparent stages IA, IC, and II were observed in 10, 10, and 2 cases, respectively. The average operation time and estimated blood loss was 266.7 ± 85.7 minutes and 252 ± 388.5 mL, respectively. The average total number of harvested lymph nodes was 88.2 ± 24.4. Up-staging was found in 3 cases (13.6%), 1 case of IIIA1(ii) and 2 cases of IIIB. Lymph node metastasis was detected in 2 cases (9.0%). Intra- and postoperative complications (Clavien-Dindo classification ≥ III) occurred in 4 cases (18.1%). Three patients with recurrence were found during the median observation period of 17 months. All of these patients were diagnosed as stage III during restaging surgery. No recurrence was found in cases of stage I or II. Our study demonstrates that laparoscopic restaging surgery for early stage ovarian/fallopian tubal cancer is feasible and safe, and oncological outcomes are comparable to conventional staging surgery. Further large-scale randomized control studies are necessary to confirm the non-inferiority of laparoscopic restaging surgery compared with open surgery.

Ovarian cancer; Laparoscopic surgery; Staging surgery; Laparoscopic lymphadenectomy.

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