Comparison between laparoscopy and laparotomy in the surgical re-staging of granulosa cell tumors of the ovary

• Published in: Gynecologic oncology Vol. 157; no. 1; pp. 85 - 88
• Main Authors: Peiretti, M., Candotti, G., Fais, M.L., Ricciardi, E., Colombo, N., Zanagnolo, V., Bruni, S., Aletti, G., Maggioni, A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fertility Preservation - methods; Granulosa Cell Tumor - pathology; Granulosa Cell Tumor - surgery; Gynecologic Surgical Procedures - methods; Humans; Hysterectomy - methods; Laparoscopy; Laparoscopy - methods; Laparotomy; Laparotomy - methods; Middle Aged; Neoplasm Staging; Ovarian granulosa cell tumor; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Reoperation; Retrospective Studies; Salpingo-oophorectomy - methods; Surgical restaging; Young Adult; Surgical restaging; Laparoscopy; Laparotomy; Ovarian granulosa cell tumor
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2019.12.040

To evaluate the role of laparoscopic (LPS) and laparotomic (LPT) re-staging in patients with incompletely surgically staged ovarian granulosa cell tumors (OGCT). We conducted a medical chart retrospective analysis of all patients with sex cord stromal tumors (SCSTs) who were managed in our division between March 1994 and March 2017. After a complete review of surgical and pathological notes, patients with incomplete staging were restaged according to the FIGO guidelines. Statistical analysis was conducted using Statistical Package version 20.0 for Windows (SPSS, Inc., Chicago, Illinois). Out of a total of 170 patients SCSTs, 84 patients (49,5%) received primary surgery that included a hysterectomy; 86 patients (50,5%) underwent fertility-sparing surgery. Eighty-one patients (48%) with diagnosis of OGCT were incompletely surgically staged at another institution. We evaluated our results in terms of laparoscopic approach (56 patients) and open treatment (25 patients). Among the IA patient's group, 1 was upstaged to IIB stage and 2 to IIIB; among patients with IC stage, 1 was upstaged to IIA, 2 to IIB and 1 to IIIB stage. Adjuvant chemotherapy was given to the upstaged patients with final stage IIB-IIIC. No statistically significant difference between laparoscopy and open-surgery was detected in terms of upstaged patients after second surgery (p = 0,36). According to our series, laparoscopic restaging compared to the open approach seems to be a feasible and efficient technique to complete surgical staging in patients with GCTs incorrectly staged. Surgical restaging seems to upstage a considerable number of OGCT, mainly in the initial stage IC group of patients. However, the impact of restaging on final outcome and survival remains to be demonstrated. •Ovarian granulosa cell tumor (OGCT) represents 3% to 5% of all ovarian neoplasms.•FIGO stage is one of the most important prognostic factors in OGCTs.•Re-staging operation is a reoperation after incomplete evaluation during initial surgery.•To our knowledge, there is no report concerning laparoscopic and laparotomic restaging of OGCT published to date.•Surgical restaging seems to have a role in the management of OGCT, mainly in initial stage IC group of patients.