Comparison of surgical approach to staging operation for endometrial cancer including pelvic and paraaortic lymphadenectomy

Hahn, Ho Suap; Yoon, Seok Geun; Kim, Woo Chul; Choi, Hong Jun; Lee, In Ho; Kwon, Yong Soon; Kim, Tae Jin; Lim, Kyung Taek; Lee, Ki Heon; Shim, Jae Uk; Mok, Jung Eun

Abstract

OBJECTIVE
To compare laparoscopic surgery with laparotomy in comprehensive surgical staging of endometrial cancer.
METHODS
We retrospectively analyzed the medical records of 272 patients with endometrial adenocarcinoma treated by staging operation including pelvic and paraaortic lymphadenectomy between January, 1996 and December, 2007.
RESULTS
There was no significant difference between the two groups in terms of age, body mass index, or histologic type, but in the laparotomy group, grade and surgical stage were significantly higher. All the patients, 182 in the laparotomy and 90 in the laparoscopy group, had lymphadenectomy, and the mean number of pelvic and paraaortic lymph nodes (LNs) obtained were 33.1+/-13.2 and 16.1+/-11.6 in the laparoscopy group, and 32.5+/-14.5 and 19.0+/-12.7 in the laparotomy group, respectively; these differences were not statistically significant. In the laparoscopy group, the operating time and postoperative hospital length of stay were shorter than in the laparotomy group, as were the pre- and post-operative hemoglobin changes. There were no significant differences between the two groups in terms of intra- or post-operative complications, but positive lymph nodal metastasis and conducting of postoperative adjuvant therapy were highter in the laparotomy group. The operative technique did not influence overall or disease-free survival after adjusting for several confounding factors.
CONCLUSION
Laparoscopic-assisted surgical staging for endometrial cancer required a shorter operating time, shorter postoperative hospital stay, and lower blood loss compared to traditional laparotomy staging, and can be a good therapeutic option for staging operation including lymphadenectomy of endometrial cancer.