The value of surgical staging in the early stages of ovarian carcinoma

: The value of surgery in early ovarian cancer was assessed in a retrospective analysis of prognostic factors in all 222 patients with primary stage I epithelial ovarian carcinoma treated in this department between 1975 and 1987. Only cellular differentiation grade (p less than 0.03) and surgical procedure - total abdominal hysterectomy, bilateral salpingo-oophorectomy +/- omentectomy vs. unilateral salpingo-oophorectomy - (p less than 0.02) were of significant influence on estimated survival (Cox model). All other factors (age, FIGO stage, integrity of the capsule, uni-vs. bilaterality, histology) were of no prognostic importance. Unilateral salpingo-oophorectomy without any additional staging reduces the 5-year survival probability (62% vs. 84%). Future prospective studies on adjuvant therapy must be based on exact staging during surgical management before randomisation. Determination of cellular differentiation is also essential.