Laparoscopic staging of early ovarian carcinoma

PURPOSE OF REVIEW: A European randomized trial on early stage ovarian cancer confirmed the importance of accurate staging to select candidates for adjuvant chemotherapy. Since early-stage disease is often discovered incidentally, staging is not always carried out or inadequately performed at the time of primary surgery. Laparoscopy was reported more than 10 years ago as a method of performing the staging procedure while avoiding the morbidity from a classical midline incision. RECENT FINDINGS: Several teams have recently published their results on laparoscopic staging. Updated results of an earlier series in addition to other recent studies are discussed. All highlight the advantages and limits of the method. SUMMARY: Complete laparoscopic management seems feasible in selected cases of apparently early stage ovarian cancer. Re-staging procedures remain an ideal indication for laparoscopy in early adnexal carcinomas. Due to the critical nature of the information obtained, this approach should only be reserved for teams trained in advanced laparoscopy.