Evaluation of surgical staging in stage I low malignant potential ovarian tumors

Snider, D. David; Stuart, Gavin; Nation, Jill; Robertson, D. Ian

doi:10.1016/0090-8258(91)90103-c

Cited by 75 publications

(51 citation statements)

References 14 publications

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“…Yazigi et al 7 speculated that 24% of upstaging for 29 patients with borderline tumours was initially presumed as stage I or II. In another study, Snider et al 8 reported 31% of upstaging of serous borderline tumours. Interestingly, they did not find any upstaging patients with mucinous borderline tumours.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Querleu¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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Objectives To review our experience with the laparoscopic restaging procedure of presumed early stage borderline ovarian tumours. Design Retrospective study.Setting Cancer centre.Population Thirty patients with presumed stage I borderline ovarian tumours after limited initial surgery.Methods From April 1991 to May 2001, the patients were laparoscopically reassessed. The procedure involved peritoneal cytology, exploration of the peritoneal cavity, infracolic omentectomy, directed or random peritoneal biopsies, and when appropriate, contralateral oophorectomy and hysterectomy and appendectomy. Medical records were reviewed for patients' age, interval time between procedures, tumour stage, histological type, operative time, hospital stay, peri-operative complications and follow up. Main outcome measures Seroperative and postoperative data, pathology and clinical follow up.Results Laparoscopic restaging was completed in all 30 (100%) identified patients. The mean age was 34.8 (10.5) years; the delay between initial operation and restaging laparoscopy averaged 9.8 (6.6) weeks. The mean operative time was 165.4 (53.8) minutes, and the mean hospital stay was 2.7 (1.3) days. There were two (7.0%) major complications related directly to the procedure. Eight (26.6%) patients were upstaged. Mean follow up was 29.1 (6.6) months, all patients are alive and one (3.2%) recurrence was observed. Conclusions Laparoscopic approach of restaging for borderline ovarian tumours is an accurate safe procedure.It is associated with an acceptable rate of minor complications, it has similar morbidity associated with laparotomy and it minimises the incidence of infertility in the young patients. Whenever staging of borderline ovarian tumours is to be considered in an individual patient, laparoscopy provides a suitable alternative approach.

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Section: Discussionmentioning

confidence: 93%

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Querleu¹

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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“…Although accurate staging is crucial for the analysis of patient cohorts, not only in terms of effects of treatment but also in terms of prognostic factors, it seems that the recurrence and mortality rates do not differ substantially between these works. This question was investigated by Fauvet et al [38], Snider et al [24] and du Bois et al [39] analyzing the role of restaging surgery in BOT. An upstaging rate of 14.8% was reported, but there was no difference in recurrence rates [38].…”

Section: Discussionmentioning

confidence: 99%

“…Snider et al [24] conclude that the low yield of staging in patients with mucinous tumors (0%) does not warrant a second operation. The higher yield of staging in patients with serous tumors (30.8%) suggests that the likelihood of upstaging the disease exceeds the potential morbidity, and the procedure may be warranted [24].…”

Section: Discussionmentioning

confidence: 99%

“…Incomplete staging showed an elevated risk for recurrence compared with comprehensive staging (hazard ratio [HR]: 1.77; 95% CI: 1.15-2.71; p 5 .0091) and restaging after initial surgery had a beneficial impact with respect to progress-free survival (HR: 0.577; 95% CI: 0.36 -0.92; p 5 .0214) [39]. Snider et al [24] conclude that the low yield of staging in patients with mucinous tumors (0%) does not warrant a second operation. The higher yield of staging in patients with serous tumors (30.8%) suggests that the likelihood of upstaging the disease exceeds the potential morbidity, and the procedure may be warranted [24].…”

Section: Discussionmentioning

confidence: 99%

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A Meta-Analysis on the Impact of Platinum-Based Adjuvant Treatment on the Outcome of Borderline Ovarian Tumors With Invasive Implants

et al. 2015

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Background. Treatment of borderline ovarian tumors (BOTs) remains contentious, and there is no consensus regarding therapy for BOTs with invasive implants (BOTi). The benefits of platinum‐based adjuvant treatment were evaluated in patients with BOTi at primary diagnosis. Methods. The PubMed database was systematically searched for articles using the following terms: ((borderline) OR (low malignant potential) AND (ovarian)) AND ((tumor) OR (cancer)) AND (invasive implants) AND ((follow‐up) OR (survival) OR (treatment) OR (chemotherapy) OR (adjuvant treatment) OR (surgery) OR (surgical treatment)). Results. We identified 27 articles including 3,124 patients, 181 with invasive implants. All studies provided information regarding mortality or recurrence rates. Central pathological examination was performed in 19 studies. Eight studies included more than 75% stage I patients; 7 included only advanced‐stage patients, and 14 included only serous BOT. The pooled recurrence estimates for both treatment groups (adjuvant treatment: 44.0%, upfront surgery: 21.3%) did not differ significantly (p = .114). A meta‐analysis of the 6 studies providing separate mortality data for both treatment groups favored surgical treatment only, but this difference did not reach statistical significance (.05 < p < .1; odds ratio: 0.33; 95% confidence interval: 0.09–1.71; p = .086). We were unable to pool the results of the included studies because not all studies registered events in both treatment groups. Egger's regression indicated low asymmetry of the studies (p = .39), and no heterogeneity was found (I2 = 0%). Conclusion. We did not find evidence supporting platinum‐based adjuvant therapy for BOT with invasive implants.

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“…Finally, Trimble and Trimble [1] recommended a caseby-case approach, taking into account the adequacy of initial surgery, the histologic subtype, and a potential recommendation for adjuvant therapy. Although restaging operations led to upstaging in up to 47% of cases in previous studies, the risk-benefit balance must be carefully weighed, especially when laparotomy is required [21][22][23][24][25]. Recently, Querleu et al [26] demonstrated the feasibility of laparoscopic restaging, reporting an upstaging rate of 26.6% and minimal perioperative morbidity.…”

mentioning

confidence: 96%

Laparoscopic restaging of borderline ovarian tumors

et al. 2007

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Evaluation of surgical staging in stage I low malignant potential ovarian tumors

Cited by 75 publications

References 14 publications

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours

A Meta-Analysis on the Impact of Platinum-Based Adjuvant Treatment on the Outcome of Borderline Ovarian Tumors With Invasive Implants

Laparoscopic restaging of borderline ovarian tumors

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