J Gynecol Oncol.  2019 Mar;30(2):e24. 10.3802/jgo.2019.30.e24.

Laparoscopic surgery for low, intermediate and high-risk endometrial cancer

• Vardar MA
• Gulec UK
• Guzel AB
• Gumurdulu
• Khatib G
• Seydaoglu

• KMID: 2457136
• DOI: http://doi.org/10.3802/jgo.2019.30.e24

Abstract

OBJECTIVE
The aim of the present study was to compare the long-term outcomes of the laparotomy (LT) and laparoscopic surgery and to evaluate the results according to low, intermediate, and high-risk groups of endometrial cancer (EC).
METHODS
We identified 801 patients with EC and these patients were classified as group 1, who underwent LT (n=515); and group 2, who underwent laparoscopy (LS) (n=286). Patient's demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion, myometrial invasion, lymph node involvement, and risk groups, peri- and post-operative outcomes, and survival outcomes were compared between the groups according to risk classification. Survival outcomes were assessed using Kaplan-Meier method.
RESULTS
The demographic characteristics of both groups were similar except age. Shorter hospital stay and fewer complications were observed in group 2. The overall survival (OS) were similar in the low, low-intermediate, high-intermediate and high-risk groups (p=0.269, 0.476, 0.078, and 0.085; respectively) for LS compared to LT. The covariate analysis revealed that the death and recurrence risks were approximately twice higher in the LT group than in the LS group (odds ratio [OR]=1.9; 95% confidence interval [CI]=1.2-3.1 for OS; OR=2.0; 95% CI=1.2-3.3 for disease-free survival).
CONCLUSION
The results of our study support the well-known positive aspects of LS as well as safe and effective use in cases of intermediate and high-risk EC.

Keyword

Endometrial Cancer; Laparoscopy; Laparotomy; Prognostic Factors; Risk Assessment

MeSH Terms

Classification
Demography
Endometrial Neoplasms*
Female
Humans
Laparoscopy*
Laparotomy
Length of Stay
Lymph Nodes
Methods
Recurrence
Risk Assessment