Journal of Modern OncologyJournal of Modern Oncology1815-14341815-1442LLC Obyedinennaya Redaktsiya2955310.26442/1815-1434_2018.2.61-65Review ArticleSurgery for early-stage ovarian cancerNechushkinaV M-MorkhovK Yuk_morkhov@mail.ruAbduragimovaZ Tzarrems@gmail.comKuznetsovV V-SelchukV Yu-DmitrievV Nvadd@mail.ruN.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian FederationN.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian FederationA.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian FederationBelgorod State National Research UniversityBelgorod Oncology Dispensary15062018202616509042020Copyright © 2018, Consilium Medicum2018Purpose of the literature review: to analyze recent studies of surgical treatment of stage I-II ovarian cancer. Key issues. Individual steps of surgery and their significance, impact of the extent of surgery on the survival and adjuvant treatment, fertility-sparing surgery in young patients and safety of laparoscopic surgery are discussed. Conclusion. Optimal staging of early ovarian cancer was found to be significantly associated with overall and recurrence-free survival.stage I-II epithelial ovarian cancersurgerylaparoscopyfertility-sparing treatmentрак яичников I-II стадийхирургическое лечениелапароскопические операцииорганосохраняющее лечение[Давыдов М.И., Аксель Е.М. Стандартизованные показатели онкоэпидемиологической ситуации 2015 г. Евразийский онкологический журн. 2017; 5 (2): 261-317.][ESGO guidelines for ovarian cancer surgery. URL: https://guidelines. esgo.org/media/2017/03/ESGO_ovarian_cancer_surgery_brA5_V01-website.pdf][Pecorelli S, Ngan H.Y.S, Hacker N.F. Staging classifications and clinical practice guidelines for gynaecological cancers. URL: https://www.figo.org][Prat J. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. J Gynaecol Obstet 2014; 124: 1-5.][Sainz de la Cuesta R, Goff B.A, Fuller A.FJr et al. Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms. Obstet Gynecol 1994; 84 (1): 1-7.][Higashi M, Kajiyama H, Shibata K et al. Survival impact of capsule rupture in stage I clear cell carcinoma of the ovary in comparison with other histological types. Gynecol Oncol 2011; 123 (3): 474-8.][Paulsen T, Kaern J, Trope C. Improved 5-year disease-free survival for FIGO stage I epithelial ovarian cancer patients without tumor rupture during surgery. Gynecol Oncol 2011; 122: 83-8.][Тюляндин С.А., Коломиец Л.А., Морхов К.Ю. и др. Практические рекомендации по лекарственному лечению РЯ, первичного рака брюшины и рака маточных труб. Злокачественные опухоли. 2017; 3 (Прил. 2): 135-45.][Young R.C, Decker D.G, Wharton J.T et al. Staging laparotomy in early ovarian cancer. JAMA 1983; 250 (22): 3072-6.][Buchsbaum H.J, Brady M.F, Delgado G et al. Surgical staging of carcinoma of the ovaries. Surg Gynecol Obstet 1989; 169 (3): 226-32.][Arie A.B, McNally L, Kapp D.S, Teng N.N. The omentum and omentectomy in epithelial ovarian cancer: a reappraisal: part II - The role of omentectomy in the staging and treatment of apparent early stage epithelial ovarian cancer. Gynecol Oncol 2013; 131 (3): 784-90.][Lee Y, Kim H.S, Chung H.H et al. The role of omentectomy and random peritoneal biopsies as part of comprehensive surgical staging in apparent early-stage epithelial ovarian cancer. Ann Surg Oncol 2014; 21 (8): 2762-6.][Timmers P.J, Zwinderman K, Coens C et al. Lymph node sampling and taking of blind biopsies are important elements of the surgical staging of early ovarian cancer. Int J Gynecol Cancer 2010; 20 (7): 1142-7.][Verleye L, Ottevanger P.B, van der Graaf W et al.; Gynaecological Cancer Group (GCG) of European Organisation for Research and Treatment of Cancer (EORTC). EORTC-GCG process quality indicators for ovarian cancer surgery. Eur J Cancer 2009; 45 (4): 517-26.][Ayhan A, Gultekin M, Celik N.Y et al. Occult metastasis in early ovarian cancers: risk factors and associated prognosis. Am J Obstet Gynecol 2007; 196 (1): e1-6.][Fournier M, Stoeckle E, Guyon F et al. Lymph node involvement in epithelial ovarian cancer: sites and risk factors in a series of 355 patients. Int J Gynecol Cancer 2009; 19 (8): 1307-13.][Morice P, Joulie F, Camatte S et al. Lymph node involvement in epithelial ovarian cancer: analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg 2003; 197 (2): 198-205.][Schmeler K.M, Tao X, Frumovitz M et al. Prevalence of lymph node metastasis in primary mucinous carcinoma of the ovary. Obstet Gynecol 2010; 116 (2): 269-73.][Garcia-Soto A.E, Boren T, Wingo S.N et al. Is comprehensive surgical staging needed for thorough evaluation of early-stage ovarian carcinoma? Am J Obstet Gynecol 2012; 206 (3): 242.][Le T, Adolph A, Krepart G.V et al. The benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma. Gynecol Oncol 2002; 85 (2): 351-5.][Timmers P.J, Zwinderman A.H, Coens C et al. Understanding the problem of inadequately staging early ovarian cancer. Eur J Cancer 2010; 46 (5): 880-4.][Mayer A.R, Chambers S.K, Graves E et al. Ovarian cancer staging: does it require a gynecologic oncologist? Gynecol Oncol 1992; 47 (2): 223-7.][Signorelli M, Fruscio R, Ceppi L et al. The role of pelvic and aortic lymphadenectomy at second look surgery in apparent early stage ovarian cancer after inadequate surgical staging followed by adjuvant chemotherapy. Gynecol Oncol 2014; 132 (2): 312-5.][Trimbos J.B, Vergote I, Bolis G et al. European Organisation for Research and Treatment of Cancer-Adjuvant ChemoTherapy in Ovarian Neoplasm. Impact of adjuvant chemotherapy and surgical staging in early-stage ovarian carcinoma: European Organisation for Research and Treatment of Cancer-Adjuvant ChemoTherapy in Ovarian Neoplasm trial. J Natl Cancer Inst 2003; 95 (2): 113-25.][Trimbos B, Timmers P, Pecorelli S et al. Surgical staging and treatment of early ovarian cancer: long-term analysis from a randomized trial. J Natl Cancer Inst 2010; 102 (13): 982-7.][Chan J.K, Tian C, Teoh D et al. Survival after recurrence in early-stage high-risk epithelial ovarian cancer: a Gynecologic Oncology Group study. Gynecol Oncol 2010; 116 (3): 307-11.][Travis L.B, Curtis R.E, Boice J.D et al. Second malignant neoplasms among long-term survivors of ovarian cancer. Cancer Res 1996; 56 (7): 1564-70.][Chi D.S, Abu-Rustum N.R, Sonoda Y et al. The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers. Am J Obstet Gynecol 2005; 192 (5): 1614-9.][Zivanovic O, Sonoda Y, Diaz J.P et al. The rate of port-site metastases after 2251 laparoscopic procedures in women with underlying malignant disease. Gynecol Oncol 2008; 111 (3): 431-7.][Duska L.R, Chang Y.C, Flynn C.E et al. Epithelial ovarian carcinoma in the reproductive age group. Cancer 1999; 85 (12): 2623-9.][Plaxe S.C, Braly P.S, Freddo J.L et al. Profiles of women age 30-39 and age less than 30 with epithelial ovarian cancer. Obstet Gynecol 1993; 81 (5): 651-4.][Rodriguez M, Nguyen H.N, Averette H.E et al. National survey of ovarian carcinoma XII. Epithelial ovarian malignancies in women less than or equal to 25 years of age. Cancer 1994; 73 (4): 1245-50.][Huber D, Cimorelli V, Usel M et al. How many ovarian cancer patients are eligible for fertility-sparing surgery? Eur J Obstet Gynecol Reprod Biol 2013; 170 (1): 270-4.][Schilder J.M, Thompson A.M, DePriest P.D et al. Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy. Gynecol Oncol 2002; 87 (1): 1-7.][Zanetta G, Chiari S, Rota S et al. Conservative surgery for stage I ovarian carcinoma in women of childbearing age. Br J Obstet Gynaecol 1997; 104 (9): 1030-5.][Park J.W, Kim D.Y, Suh D.S et al. Outcomes of fertility-sparing surgery for invasive epithelial ovarian cancer: oncologic safety and reproductive outcomes. Gynecol Oncol 2008; 110 (3): 345-53.][Schlaerth A.C, Chi D.S, Poynor E.A et al. Long-term survival after fertility-sparing surgery for epithelial ovarian cancer. Int J Gynecol Cancer 2009; 19 (7): 1199-204.][Anchezar J.P, Sardi J, Soderini A. Long-term follow-up results of fertility sparing surgery in patients with epithelial ovarian cancer. J Surg Oncol 2009; 100 (1): 55-8.][Kajiyama H, Shibata K, Suzuki S et al. Is there any possibility of fertility-sparing surgery in patients with clear-cell carcinoma of the ovary? Gynecol Oncol 2008; 111 (3): 523-6.][Fruscio R, Corso S, Ceppi L et al. Conservative management of early-stage epithelial ovarian cancer: results of a large retrospective series. Ann Oncol 2013; 24 (1): 138-44.][Kajiyama H, Mizuno M, Shibata K et al. Recurrence-predicting prognostic factors for patients with early-stage epithelial ovarian cancer undergoing fertility-sparing surgery: a multi-institutional study. Eur J Obstet Gynecol Reprod Biol 2014; 175: 97-102.][Ditto A, Martinelli F, Lorusso D et al. Fertility sparing surgery in early stage epithelial ovarian cancer. J Gynecol Oncol 2014; 25 (4): 320-7.][Kajiyama H, Shibata K, Mizuno M et al. Long-term survival of young women receiving fertility-sparing surgery for ovarian cancer in comparison with those undergoing radical surgery. Br J Cancer 2011; 105 (9): 1288-94.][Satoh T, Hatae M, Watanabe Y et al. Outcomes of fertility-sparing surgery for stage I epithelial ovarian cancer: a proposal for patient selection. J Clin Oncol 2010; 28 (10): 1727-32.][Wright J.D, Shah M, Mathew L et al. Fertility preservation in young women with epithelial ovarian cancer. Cancer 2009; 115 (18): 4118-26]