Comparison of Laparoscopic and Open Surgery for Women With Early-Stage Epithelial Ovarian Cancer

OBJECTIVE: This study evaluated the oncologic outcomes of laparoscopy and laparotomy in the management of early-stage ovarian cancer patients. METHODS: We conducted an observational study of women diagnosed with International Federation of Gynecology and Obstetrics (FIGO) 2014 stage I ovarian cancer who underwent surgery at the West China Second University Hospital from 2012 to 2020. Patients who received adjuvant chemotherapy before surgery, those with non-epithelial histopathological types, or those with insufficient data were excluded. Using propensity score matching, data from consecutive laparoscopic patients treated by laparoscopy were matched 1:2 with a cohort of patients undergoing open surgery. The operative and survival outcomes among the matched cohorts were examined using the Kaplan–Meier method. RESULTS: Among 200 eligible patients, 74 patients undergoing laparoscopy were compared with a cohort of 126 patients undergoing open surgery. Baseline characteristics were similar between groups after matching. Patients who had laparoscopy had a shorter operative time (P = 0.001), a shorter hospital stay (P <0.001), and lower blood loss (P = 0.001) than patients who had open surgery. The median (range) follow-up period was 43.0 (38.8–47.2) and 45.0 (36.0–54.0) months for cases and controls, respectively (P <0.001). There are no significant differences in progression-free survival (P = 0.430, log-rank test) and overall survival (P = 0.067, log-rank test) between the two groups. CONCLUSIONS: There is no difference in prognosis between laparoscopic and open surgery in women with stage I epithelial ovarian cancer. Laparoscopic treatment of early-stage ovarian cancer is safe and feasible for stage I epithelial ovarian cancer patients.