Retrospective chart review of all patients undergoing surgery for
endometrial cancer between 8/2004 and 12/2008. Complications graded and analyzed using Common Toxicity Criteria for Adverse Events ver. 4.03 classification.
RESULTS: 168 women underwent surgery: laparoscopy n=65,
laparotomy n=103. Overall median body mass index 36.2 (range, 18.1 to 72.7) with similar distributions for age, body mass index and performance of
lymph node dissection between groups. Following laparoscopy vs.
laparotomy the percent rate of overall complications 53.8:73.8 (p=0.01), grade ≥3 complications 9.2:34.0 (p<0.01), ≥3
wound complications 3.1:22.3 (p<0.01) and ≥3
wound infection 3.1:20.4 (p=0.01) were significantly lower after laparoscopy. In a logistic model there was no effect of body mass index (≥36 and<36) on complications after laparoscopy in contrast to
laparotomy. Para-aortic
lymph node dissection was performed by laparoscopy 19/65 (29%): by
laparotomy 34/103 (33%) p=0.61 and pelvic
lymph node dissection by laparoscopy 21/65 (32.3%): by
laparotomy 46/103 (44.7%) p=0.11. Logistic regression analysis revealed that for patients undergoing laparoscopy for stage I disease there was an inverse relationship between the performance of both para-aortic
lymph node dissection and pelvic
lymph node dissection and increasing body mass index (p=0.03 and p<0.01 respectively) in contrast to the
laparotomy group where there was a trend only (p=0.09 and 0.05).
CONCLUSION: