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Updated: Aug 5, 2026
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
Adnexectomy without intraoperative capsule rupture for early ovarian cancer: survival comparison between minimally
Koji Matsuo1, Mariya Kobayashi2, Aoi Yamaguchi3
1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Department of Obstetrics and Gynecology, Los Angeles General Medical Center, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
Abstract:
This comparative effectiveness study of 15,572 patients with stage IA ovarian cancer who underwent primary anti-cancer surgery with adnexectomy from 2012 to 2022, identified in the Commission-on-Cancer's National Cancer Database, compared the overall survival of 5867 patients who underwent minimally invasive surgery with that of 9705 patients who underwent open surgery. In the propensity score inverse probability of treatment weighting cohort for node-staged cases, the 5-year overall survival rates were 92.4% (95% confidence interval 91.1% to 93.7%) for the minimally invasive surgery group and 92.0% (95% confidence interval 91.2% to 92.7%) for the open surgery group. Controlling for postoperative chemotherapy use, the adjusted hazard ratio for minimally invasive surgery compared with open surgery was 0.94 (95% confidence interval 0.80 to 1.11). This survival association was consistent when including node-unstaged cases or for histology subgroups, including type I epithelial ovarian cancer, type II epithelial ovarian cancer, sex cord-stromal tumors, and malignant germ cell tumors. Associations were also similar when the modality of minimally invasive surgery was assessed as robot-assisted or conventional laparoscopic surgery. In conclusion, the results of this comparative effectiveness study suggest that minimally invasive surgery may not negatively influence overall survival for stage IA ovarian cancer when adnexectomy is performed without ovarian capsule rupture during surgery.
