Purpose of review
To update the available information and to report on how the recent literature has better defined the role of laparoscopy for the management of gynaecological malignancies.
When compared with laparotomy, laparoscopy provides a similar outcome with a shorter hospitalization, an earlier recovery, and an improved quality of life for the treatment of endometrial cancer. Recent reports in the literature on cervical cancer management now include follow-up data; however, only one study included a control group. These studies confirm the feasibility of radical hysterectomy by laparoscopy. The 2-year disease-free and overall survivals were similar in patients treated by laparoscopy and laparotomy in the study that included a control group. The role of laparoscopy for early ovarian cancer is limited by the absence of available data on upstaging. For advanced ovarian carcinoma, new applications of laparoscopy, such as laparoscopic fluorescence detection after intraperitoneal application of 5-aminolevulinic acid, have been reported but the real utility needs further investigation. One of the challenges for the development of laparoscopic surgery is the difficulty for physicians of acquiring advanced laparoscopic surgical skills.
The feasibility and safety of laparoscopy for most of the surgical procedures that are used for gynaecological malignancies are now established from cohort or case–control analytical studies. The absence of large phase III studies needs to be balanced by the relatively low incidence of cervical and ovarian cancer.
Abbreviations ALA: 5-aminolevulinic acid; DFS: disease-free survival; FIGO: Federation of Gynecology and Obstetrics; SGO: Society of Gynecologic Oncologists.