THE ROLE OF STAGING LAPAROTOMY IN GRADING GYNECOLOGICAL MALIGNANCIES

Background  Staging laparotomy can provide optimal care for gynecological malignancies by avoiding over treatment and under treatment. Objectives  The aim was to explore the difference between surgical and clinical disease staging of gynecological malignancies.  Patients and Methods A retrospective observational study was performed on 30 women who were operated on for gynecological malignancies and were admitted to the Sulaimani Maternity Teaching Hospital from January 2019 to December 2020. Inclusion criteria included women diagnosed with gynecological malignancies before staging laparotomy. However, exclusion criteria included previous abdominal surgeries for other gynecological malignancies. In addition, demographic features, previous diagnostic methods, and intraoperative staging were recorded. Results The mean±SD (standard deviation) age was 51.8±14.9 years (range, 12 to 72), and the majority (56.7%) was between 50-69 years. The mean±SD of patients’ gravida and para were 4.5±3.5 (range, 0-12) and 3.4±2.8 (range, 0-8), respectively. In addition, 20% of women had a personal history (13.3%) of tumors or familial history (6.7%)—most women (50%) presented with abnormal vaginal bleeding, either postmenopausal or menstrual abnormalities. Most women with endometrial tumors (50%) had been afflicted with adenocarcinoma (endometrioid type); however, the most common types of ovarian tumors were granulosa cell tumor, papillary serous adenocarcinoma, and malignant ovarian dysgerminoma in 10%, 10%, and 6.7%, respectively. The association between clinical staging and staging laparotomy was significant. There was a 60% upgrade from a lower stage to a higher stage; however, downgrading was only 3.3%.  Conclusion The current study showed a significant association between clinical staging and staging laparotomy of gynecological malignancies.