Dr. Karam on the Use of Laparoscopy in Advanced Ovarian Cancer

Amer Karam, MD, associate clinical professor of Gynecologic Oncology at Stanford Hospital and director of Robotic Surgery and Outreach in the Division of Gynecologic Oncology at Stanford Medicine, discusses the use of laparoscopy in advanced ovarian cancer.

Any patient who comes to the clinic with advanced-stage ovarian cancer should be offered laparoscopy as a way to triage them for primary debulking surgery, says Karam. It is something that is universally applied to all of Karam’s patients prior to undergoing primary debulking surgery.

Physicians may approach borderline tumors differently, explains Karam, as the rate of advanced-stage borderline tumors is lower than is expected in high-grade ovarian cancer, as such, physicians have a higher likelihood of finding early-stage disease with these tumors.

If a patient presents with a borderline tumor, diagnostic laparoscopy can still be useful, he adds, as there are situations in which borderline tumors are spread so far inside the abdomen that surgery would not be able to resect all of the disease. For these patients, there may be a role for surgical debulking, even if they’re not left with minimal residual disease, concludes Karam.