Importance of Staging for Treatment

The value of complete staging has not been demonstrated for patients with early-stage disease, but the opposite ovary should be carefully evaluated for evidence of bilateral disease. The impact of surgical staging on therapeutic management has not been defined. However, in a study of 29 patients with presumed localized disease, 7 patients were upstaged after complete surgical staging.[2]

In two other studies, 16% and 18% of patients with presumed localized borderline tumors were upstaged as a result of a staging laparotomy.[3,4] In one of these studies, the yield for serous tumors was 30.8%, compared with 0% for mucinous tumors.[3]

In another study, patients with localized intraperitoneal disease and negative lymph nodes had a low incidence of recurrence (5%), whereas patients with localized intraperitoneal disease and positive lymph nodes had a statistically significant higher incidence of recurrence (50%).[5]