OVARIAN CANCERS RELATED TO MINIMAL ACCESS SURGERY

Objective To review the clinical features of women with ovarian cancer on whom minimal access surgery has been performed and to determine gu idelines for the safe use of minimal access surgery for adnexal masses . Design Postal survey of members of the British Gynaecological Cancer Society (BGCS) and retrospective case review. Results BGCS consultant s used ultrasound scanning (70%) and serum CA-125 estimations (53%) pr ior to adnexal mass surgery. The membership felt that adnexal masses w ith solid elements, diameter greater than 8 cm, multi-ocular or bilate ral cysts or increased blood flow on Doppler scanning should not be op erated on by minimal access surgery. A positive family history was als o considered to be a contraindication. A total of 29 cases of ovarian cancer were identified on whom MAS had been performed. The incidence o f cases was 4.1% of referrals to a tertiary referral centre (the Royal Marsden Hospital), The median age of patients was 37 years (range 20 to 68 years) and 13 had Stage I cancers. The mean delay between diagno sis and staging was 6.5 weeks. Conclusion Guidelines on the use of min imal access surgery in the management of adnexal masses need to be agr eed. Women who have an ovarian cancer diagnosed whilst having minimal access surgery should have an accepted staging procedure, We do not re commend the routine use of minimal access surgery for the treatment of ovarian cancer outside a trial.