Minimally invasive approach in endometrial cancer with lower uterine segment involvement in stage ≥ II: A retrospective study.

Abstract

OBJECTIVE:

To compare oncological outcomes in women with lower uterine segment involvement (LUSI) in endometrial carcinoma (EC) stage ≥ II - staged by a minimally invasive surgery (MIS) versus laparotomy.

STUDY DESIGN:

A retrospective multi-center cohort study. Univariate analysis, Kaplan-Meier survival and Cox proportional hazard analysis were performed to compare between women staged by MIS and those staged by laparotomy.

RESULTS:

Over a median follow-up period of 3 years (interquartile range, 1.5-6 years) 212 women were included, 68 (32.1%) were surgically staged by MIS. Stages of disease did not vary between MIS and laparotomy and were 32.1%, 51.9%, and 16.0%, in stages II, III and IV - respectively. Adjuvant radiation and chemotherapy rate did not differ between groups. Overall recurrence rate was comparable (p = 0.084). Locoregional recurrence rate was higher in the MIS group odds ratio 2.17, 95% confidence interval 1.19-4.20). Overall and progression free survival were similar in both groups (log rank test p = 0.08 and p = 0.912 respectively). In Cox regression model adjusting for age, comorbidities, tumor grade, stage and adjuvant therapy, route of surgery (MIS vs. laparotomy) was not associated with overall survival (p = 0.169).

CONCLUSIONS:

In women with advanced EC and LUSI, although MIS is associated with locoregional recurrences, survival is comparable to laparotomy.

• Authors: Tamar Perri, Gabriel Levin, Limor Helpman, Ram Eitan, Zvi Vaknin, Ofer Lavie, Alon Ben Arie, Amnon Amit, Tally Levy, Ahmet Namazov, Inbar Ben Shachar, Ilan Atlas, Ilan Bruchim, Liron Kogan, Ofer Gemer
• Journal: European journal of obstetrics, gynecology, and reproductive biology (Eur J Obstet Gynecol Reprod Biol) Vol. 268 Pg. 43-47 (Jan 2022) ISSN: 1872-7654 [Electronic] Ireland
• PMID: 34800816 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2021 Elsevier B.V. All rights reserved.

Topics

• Cohort Studies
• Endometrial Neoplasms (pathology, surgery)
• Female
• Humans
• Hysterectomy
• Laparotomy
• Minimally Invasive Surgical Procedures
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Retrospective Studies