Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

The value of surgical staging in patients with apparent early stage epithelial ovarian carcinoma

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Menopausal hormone therapy prior to the diagnosis of ovarian cancer is associated with improved survival

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Incidence of vulvar high-grade precancerous lesions and cancer in Denmark before and after introduction of HPV vaccination

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Non-epithelial ovarian cancer in Denmark - Incidence and survival over nearly 40 years

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Noncoding RNA (ncRNA) Profile Association with Patient Outcome in Epithelial Ovarian Cancer Cases

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Postoperative mobilisation as an indicator for the quality of surgical nursing care

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: The value of surgical staging of apparent early stage epithelial ovarian carcinoma (EOC) is unclear. The aim of this study was to evaluate the importance of surgical staging on the stage of disease and treatment plan.

MATERIAL AND METHODS: All patients with apparent stage I EOC undergoing staging from 01/01/2005 to 30/06/2017 in all Danish hospitals and in the Radboud University Hospital Nijmegen, the Netherlands, were evaluated to identify the pathological findings responsible for upstaging and changes in treatment plans.

RESULTS: We included 1234 patients with apparent stage I EOC. The staging steps often missed were the biopsy from the right diaphragmatic surface (missed in 96.9% of all patients) and lymph node (LN) sampling or lymphadenectomy (missed in 65.5% of all patients). Upstaging occurred in 393 patients (31.8%) due to microscopic spread to both ovaries (0.8%); ovarian surface (5.8%); positive cytology (10.0%); fallopian tubes (3.1%), ovary (1.5%) and/or uterus serosa (1.2%); pelvic peritoneum (4.3%); LNs (4.7%); omentum (3.7%); abdominal peritoneum (0.6%) and right diaphragmatic surface (2.6%). Of the 393 upstaged patients, 138 (35.1%) had an altered treatment plan due to metastases found by surgical staging.

CONCLUSION: Staging was incomplete in most patients, mainly because a biopsy of the diaphragm was omitted. However, surgical staging led to adjuvant treatment in 35.1% of the upstaged patients. Peritoneal biopsies (para-colic gutters and right diaphragm) were of little value, since few patients had an adjustment of treatment plan due to these biopsies. Omitting these biopsies, in the absence of peritoneal abnormalities, is justifiable.

Original languageEnglish
JournalGynecologic Oncology
Volume154
Issue number2
Pages (from-to)308-313
Number of pages6
ISSN0090-8258
DOIs
Publication statusPublished - Aug 2019

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Biopsy/standards, Carcinoma, Ovarian Epithelial/pathology, Denmark, Female, Humans, Middle Aged, Neoplasm Staging/methods, Netherlands, Ovarian Neoplasms/pathology, Young Adult

ID: 59300886