Robotic Versus Laparoscopic Staging for Early Ovarian Cancer: A Case-Matched Control Study

Abstract

Study objective: To evaluate the feasibility, surgical outcome, and oncologic results observed after robotic staging compared with conventional laparoscopic staging for patients with early-stage ovarian cancer patients.

Design: A retrospective cohort study (Canadian Task Force classification II-2).

Setting: Catholic University of the Sacred Heart, Rome, Italy.

Patients: Ninety-six patients underwent minimally invasive staging for presumed stage I ovarian cancer; 32 underwent the robotic approach (cases), and 64 underwent the laparoscopic approach (controls).

Measurements and main results: There was no statistically significant difference between the 2 approaches with regard to final Fédération Internationale de Gynécologie et d'Obstétrique stage, histology, and grade of tumors. In the whole series, 15 patients (15.6%) were upstaged, with no statistically significant difference between the 2 groups. The median number of pelvic lymph nodes removed was 14 (range, 3-42) and 11 (range, 2-29) in the robotic and laparoscopic groups (p = .235), respectively. The median number of aortic lymph nodes removed was 11 (range, 3-26) and 12 (range, 1-39) in the robotic and laparoscopic groups (p = .263), respectively. The operative time was significantly shorter in the robotic group compared with the laparoscopic group (p = .043), whereas the amount of estimated blood loss was similar (p = .691). No difference was found in terms of early and postoperative complications. Overall, 72 patients were considered as requiring adjuvant treatment. Two patients experienced peritoneal recurrence.

Conclusion: The present study suggests that there is no relevant difference between the robotic and laparoscopic approaches in staging early-stage ovarian cancer. Further prospective trials are needed to confirm our results.

Keywords: Early ovarian cancer; Laparoscopy; Robotic surgery.