Minimally invasive surgery does not impair overall survival in stage IIIC endometrial cancer patients

  • Andrea PapadiaEmail author
  • Alicia Garbade
  • Maria Luisa Gasparri
  • Junjie Wang
  • Anda Petronela Radan
  • Michael D. Mueller
Gynecologic Oncology



We aimed to evaluate weather survival is impaired in stage IIIC endometrial cancer patients treated with minimally invasive surgery as compared to laparotomy.


We analyzed surgical data and oncologic outcome of histologically proven stage IIIC endometrial cancer patients who were treated at our institution via laparotomy or via laparoscopic surgery. All the patients underwent a systematic pelvic and para-aortic lymphadenectomy and a complete tumor resection. Perioperative morbidity and overall survival of the patients subjected to the two surgical approaches were compared.


Sixty-six patients with stage IIIC endometrial cancer were identified. Of these, 15 patients were operated via laparotomy and 51 via laparoscopy. The two groups were similar with regards to median age at diagnosis, BMI, histotype, number of affected lymph nodes, and median maximal diameter of the affected lymph nodes. Patients undergoing laparoscopic surgery had fewer perioperative complications, a smaller estimated blood loss, and were subjected less frequently to transfusions. Overall survival at 60 months of follow-up did not differ between the two groups. At uni- and multivariate analysis, surgical approach did not affect survival. Only age was a variable associated with overall survival.


Minimally invasive surgery has better perioperative outcomes and does not impair survival in stage IIIC endometrial cancer patients. Age at diagnosis is the only factor independently affecting survival.


Endometrial cancer Laparotomy Laparoscopy Lymph node metastases Overall survival 


Author contribution

AP: concept, manuscript writing and editing, and supervision. MDM: concept, manuscript editing, and supervision. MLG: statistical analysis, manuscript writing and editing, and supervision. JW: manuscript writing and editing, supervision. APR: Data acquisition, manuscript writing and editing, and supervision. AG: data acquisition.


This study was not funded.

Compliance with ethical standards

Conflict of interest

Andrea Papadia has no conflict of interest. Alicia Garbade has no conflict of interest. Maria Luisa Gasparri has no conflict of interest. Junjie Wang has no conflict of interest. Anda Petronela Radan has no conflict of interest. Michael D Mueller has no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity Hospital of Bern and University of BernBernSwitzerland
  2. 2.Department of Gynecology and Obstetrics“Sapienza” University of RomeRomeItaly
  3. 3.Department of Gynaecological OncologyKK Women’s and Children’s HospitalSingaporeSingapore

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