Peritoneoscopy: A Valuable Staging Tool in Ovarian Carcinoma

Abstract

Peritoneoscopy was done within 1 month of exploratory laparotomy in 30 consecutive patients, with ovarian carcinoma as part of their pretreatment evaluation. Six of the 7 patients who were thought to have ovarian carcinoma localized to the pelvis (stages I and II) were found to have advanced disease (stage III) at peritoneoscopy and thus required a change in therapy. Metastatic diaphragmatic involvement in ovarian carcinoma is common and was found in 77% of all patients studied. The routine shielding of the liver area ordinarily used with total abdominal radiotherapy would select these patients for therapeutic failure. Peritoneoscopy supplied reevaluate findings in 2 of the 7 patients having normal physical, roentgenologic, and laboratory examinations, as well as in 93% of all patients studied. "Second look" peritoneoscopy precluded the need for laparotomy in 5 of 13 patients achieving an apparent clinical remission.