Robotic Minimally-Invasive Staging in Early Stage Ovarian Cancer and Borderline Tumors

Background: Standard therapy for ovarian cancer includes laparotomy including systematic pelvic and paraaortic lymphadenectomy. Since survival rates are good in early stages, the question arises whether an aggressive surgical staging is justified. Staging laparotomy is also mandatory in borderline ovarian tumors. As the prognosis of these neoplasms is excellent, the question about less aggressive staging methods is even more urgent in these patients.Methods: Patients were identified retrospectively in the hospital's own clinical information system. Clinical data were collected, and patients were contacted for follow-up.Results: We identified 20 patients after minimally-invasive staging for ovarian cancer or borderline tumors. Postoperative complications occurred in three patients (15%). Fifteen women had malignant ovarian tumors. Six patients received compartment-based, targeted lymphadenectomy, the remaining nine underwent systematic lymphadenectomy. The mean number of harvested nodes was 37.6 (3-78; 25.9). Lymph node metastases were found in 1 patient (6.7%). Histology revealed malignant cells in the resected tissues in four of these patients (26.7%). Mean follow-up time was 55.4 months (0-93; 23.5). During this time, we observed two recurrences and two deaths (13.3%, respectively). In six women with borderline tumors, no malignancy or further manifestations of borderline tumors were found. No deaths or recurrences occurred.Conclusion: Minimally-invasive staging is feasible and might be an oncologically safe strategy in early ovarian cancer and patients with borderline tumors as their prognosis is rather excellent and rate of complications seems to be lower. Prospective randomized trials will be needed to decide on the role of laparoscopic surgery in these entities.