Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer

Medeiros LRF, Rosa DD, Bozzetti MC, Rosa MINES, Edelweiss MI, Stein AT, Zelmanowicz A, Ethur AB, Zanini RR

Published Online:

December 8, 2010

Controversial discussion has arisen among endoscopists and oncologists about the laparoscopic management of early stage ovarian tumours. This systematic review found no evidence to help quantify the value of laparoscopy for the management of early stage ovarian cancer in clinical practice.

Abstract (click to read)

Background:

Over the past ten years laparoscopy has become an increasingly common approach for the surgical removal of early stage ovarian tumours. There remains uncertainty about the value of this intervention. This review has been undertaken to assess the available evidence of the benefits and harms of laparoscopic surgery for the management of early stage ovarian cancer compared to laparotomy.

Objectives:

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

Search strategy:

Trials were identified by searching the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library Issue 2, 2007, MEDLINE (January 1990 to November 2007), EMBASE (1990 to November 2007), LILACS (1990 to November 2007), BIOLOGICAL ABSTRACTS (1990 to November 2007) and Cancerlit (1990 to November 2007). We also searched our own publication archives, based on prospective handsearching of relevant journals from November 2007. Reference lists of identified studies, gynaecological cancer handbooks and conference abstract were also scanned.

Selection criteria:

Studies including patients with histologically proven stage I ovarian cancer according to the International Federation of Gynaecology and Obstetrics (FIGO).

Studies comparing laparoscopic surgery with laparotomy for early stage ovarian cancer were only available from 1990. It was anticipated that a very small number of randomised controlled trials (RCTs) were conducted studying the management of early stage ovarian cancer. Therefore, non-randomised comparative studies, cohort studies and case-controls studies, but not studies with historical controls, were also considered.

Data collection and analysis:

Data extraction was performed independently by five review authors (LRM, DDR, MIR, MCB and MIE) who assessed study quality and quality of extracted data. Extracted data included trial characteristics, characteristics of the study participants, interventions and outcomes. The quality of non RCTs was assessed using appropriate quality evaluations tools from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and from the Newcastle-Ottawa tool for observational studies (NOS).

Main results:

No RCTs were identified. Three observational studies were identified.

Authors' conclusions:

This review has found no evidence to help quantify the value of laparoscopy for the management of early stage ovarian cancer as routine clinical practice.

This record should be cited as:

Medeiros LRF, Rosa DD, Bozzetti MC, Rosa MINES, Edelweiss MI, Stein AT, Zelmanowicz A, Ethur AB, Zanini RR. Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer. Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005344. DOI: 10.1002/14651858.CD005344.pub2

Assessed as up to date:

July 21, 2008

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Primary Review Group:

Gynaecological Cancer Group

Health topics:

Cancer > Gynaecological > Ovary

Gynaecology > Cancer > Ovary

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Laparoscopy versus laparotomy for FIGO Stage I ovarian cancer

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