Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis
Epithelial ovarian cancer is women’s fourth most common oncological cause of death. One of the main prognostic factors in ovarian cancer is the tumor stage. For instance, surgical staging of the disease is focal when choosing the best therapeutic option for each case. Although open surgery is the pr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/11/3831 |
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| author | Carlo Ronsini Francesca Pasanisi Rossella Molitierno Irene Iavarone Maria Giovanna Vastarella Pasquale De Franciscis Carmine Conte |
| author_facet | Carlo Ronsini Francesca Pasanisi Rossella Molitierno Irene Iavarone Maria Giovanna Vastarella Pasquale De Franciscis Carmine Conte |
| author_sort | Carlo Ronsini |
| collection | DOAJ |
| description | Epithelial ovarian cancer is women’s fourth most common oncological cause of death. One of the main prognostic factors in ovarian cancer is the tumor stage. For instance, surgical staging of the disease is focal when choosing the best therapeutic option for each case. Although open surgery is the prevalent approach for staging and treating ovarian cancer, the use of minimally invasive surgery (MIS) has found recent application in staging or restaging cases of early disease. Our work compares oncological outcomes after MIS staging for FIGO I epithelial ovarian cancer with the laparotomic approach. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations, we systematically searched the Pub Med and Scopus databases in February 2023. No temporal nor geographical limitation was made. We included the articles containing data about Disease-Free Survival (DFS) and Overall Survival (OS), Recurrence Rates (RR), and Upstaging Rates (UpR). We used comparative studies for the meta-analysis. After the database search and article selection, 19 works matched the inclusion criteria for the systematic review. Eleven of these were comparative studies between MIS and Open Surgical Staging (OSS) approaches for ovarian cancer staging and were included in the meta-analysis. The meta-analysis did not show a statistically significant difference between the MIS and the OSS group concerning DFS, OS, and RR. Only Upstaging Rate ≥ FIGO Stage II was statistically significative higher in the OSS group. Likewise, MIS is confirmed to be an approach with a lower profile of surgical complications. In conclusion, our study did not show one approach to be safer than the other. However, the lack of dedicated studies limits the evidence of our study. For instance, we recommend adequately selecting the specimen, minimizing the risk of spillage, and optimizing surgical staging. |
| first_indexed | 2024-03-11T03:03:49Z |
| format | Article |
| id | doaj.art-985d51ce289849bcb8b180430aafc619 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:03:49Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-985d51ce289849bcb8b180430aafc6192023-11-18T08:07:01ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011211383110.3390/jcm12113831Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-AnalysisCarlo Ronsini0Francesca Pasanisi1Rossella Molitierno2Irene Iavarone3Maria Giovanna Vastarella4Pasquale De Franciscis5Carmine Conte6Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDepartment of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie n.1, 80122 Naples, ItalyDipartimento Salute della Donna e del Bambino, Fondazione Universitaria Policlinico A. Gemelli, Largo Agostino Gemelli, 8, 00168 Rome, ItalyEpithelial ovarian cancer is women’s fourth most common oncological cause of death. One of the main prognostic factors in ovarian cancer is the tumor stage. For instance, surgical staging of the disease is focal when choosing the best therapeutic option for each case. Although open surgery is the prevalent approach for staging and treating ovarian cancer, the use of minimally invasive surgery (MIS) has found recent application in staging or restaging cases of early disease. Our work compares oncological outcomes after MIS staging for FIGO I epithelial ovarian cancer with the laparotomic approach. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations, we systematically searched the Pub Med and Scopus databases in February 2023. No temporal nor geographical limitation was made. We included the articles containing data about Disease-Free Survival (DFS) and Overall Survival (OS), Recurrence Rates (RR), and Upstaging Rates (UpR). We used comparative studies for the meta-analysis. After the database search and article selection, 19 works matched the inclusion criteria for the systematic review. Eleven of these were comparative studies between MIS and Open Surgical Staging (OSS) approaches for ovarian cancer staging and were included in the meta-analysis. The meta-analysis did not show a statistically significant difference between the MIS and the OSS group concerning DFS, OS, and RR. Only Upstaging Rate ≥ FIGO Stage II was statistically significative higher in the OSS group. Likewise, MIS is confirmed to be an approach with a lower profile of surgical complications. In conclusion, our study did not show one approach to be safer than the other. However, the lack of dedicated studies limits the evidence of our study. For instance, we recommend adequately selecting the specimen, minimizing the risk of spillage, and optimizing surgical staging.https://www.mdpi.com/2077-0383/12/11/3831ovarian cancerstagingminimally invasivelaparoscopy |
| spellingShingle | Carlo Ronsini Francesca Pasanisi Rossella Molitierno Irene Iavarone Maria Giovanna Vastarella Pasquale De Franciscis Carmine Conte Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis Journal of Clinical Medicine ovarian cancer staging minimally invasive laparoscopy |
| title | Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis |
| title_full | Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis |
| title_fullStr | Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis |
| title_short | Minimally Invasive Staging of Early-Stage Epithelial Ovarian Cancer versus Open Surgery in Terms of Feasibility and Safety: A Systematic Review and Meta-Analysis |
| title_sort | minimally invasive staging of early stage epithelial ovarian cancer versus open surgery in terms of feasibility and safety a systematic review and meta analysis |
| topic | ovarian cancer staging minimally invasive laparoscopy |
| url | https://www.mdpi.com/2077-0383/12/11/3831 |
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