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Laparoscopic Versus Open Surgery for Endometrial Cancer: a Minimum 3-Year Follow-Up Study

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The paucity of long-term oncologic results published in the literature still prevents the scientific community from cementing the place of laparoscopy as the procedure of choice for managing endometrial cancer. We present the outcomes of consecutive patients with endometrial cancer managed laparoscopically with >3-year follow-up.

Methods

Data from 117 consecutive women undergoing surgery for treatment of a clinical stage I endometrial cancer and who achieved at least 3-year follow-up were prospectively analyzed. These cases were compared with a historical cohort of 122 consecutive patients with endometrial cancer who had undergone surgery through laparotomy.

Results

The laparoscopy and laparotomy groups were similar with regard to baseline patient characteristics, surgical stage, proportion of tumors with unfavorable histology and high grade, as well as patterns of adjuvant therapy. The median (range) follow-up of surviving patients was 52 (36–84) months in the laparoscopic cohort and 80 (36–151) months in the laparotomy cohort. Women who underwent laparoscopy and those who underwent laparotomy had similar 3-year recurrence-free survival rates (91.4% vs. 88.5%, P = 0.52), as well as similar 3-year overall survival rates (94.0% vs. 93.4%, P = 1.0). Multivariate analysis showed that advanced surgical stage, unfavorable histology, and patient age >65 years significantly affect survival, regardless of the surgical approach used.

Conclusions

Cancer control in women with endometrial cancer does not appear to be worsened by laparoscopic surgery. In the absence of level I evidence to establish long-term recurrence and survival equivalence, analysis of series as they mature is crucial to fully evaluate disease control afforded by laparoscopy.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy

    Fabio Ghezzi MD, Antonella Cromi MD, PhD, Stefano Uccella MD, Gabriele Siesto MD & Maurizio Serati MD

  2. Department of Obstetrics and Gynecology, University of Verona, Verona, Italy

    Silvia Giudici MD & Massimo Franchi MD

Authors
  1. Fabio Ghezzi MD
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  2. Antonella Cromi MD, PhD
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  3. Stefano Uccella MD
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  4. Gabriele Siesto MD
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  5. Silvia Giudici MD
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  6. Maurizio Serati MD
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  7. Massimo Franchi MD
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Corresponding author

Correspondence to Fabio Ghezzi MD.

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Ghezzi, F., Cromi, A., Uccella, S. et al. Laparoscopic Versus Open Surgery for Endometrial Cancer: a Minimum 3-Year Follow-Up Study. Ann Surg Oncol 17, 271–278 (2010). https://doi.org/10.1245/s10434-009-0720-1

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  • DOI: https://doi.org/10.1245/s10434-009-0720-1

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