Oncologic outcomes for patients with endometrial cancer who received minimally invasive surgery: a retrospective observa
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ORIGINAL ARTICLE
Oncologic outcomes for patients with endometrial cancer who received minimally invasive surgery: a retrospective observational study Tomohito Tanaka1,2 · Shoko Ueda1 · Shunsuke Miyamoto1 · Shinichi Terada1 · Hiromi Konishi1 · Yuhei Kogata1 · Satoe Fujiwara1 · Yoshimichi Tanaka1 · Kohei Taniguchi2 · Kazumasa Komura2 · Masahide Ohmichi1 Received: 31 March 2020 / Accepted: 1 July 2020 © Japan Society of Clinical Oncology 2020
Abstract Background Laparoscopic hysterectomy has been performed for patients with endometrial cancer as minimally invasive surgery; however, the long-term outcomes of high-risk disease compared to open surgery remain unclear. Methods Eight hundred and eighty-three patients with endometrial cancer who underwent laparoscopic or abdominal hysterectomy were categorized into three groups. Low-risk disease was defined as stage IA disease with endometrioid carcinoma of grade 1 or 2. Uterine-confined disease was defined as stage IA disease with high-grade tumors or stage IB and II disease. Advanced disease was defined as stage III or IV disease. The progression-free survival (PFS) and overall survival (OS) rates were compared between laparoscopic and laparotomic hysterectomy. Results Among 478 patients with low-risk disease, including 226 with laparoscopy and 252 with laparotomy, the prognosis was not significantly different between the groups (3-year PFS rate, 97.4% vs. 97.1%, p = 0.8; 3-year OS rate, 98.6% vs. 98.3%, p = 0.9). Among the 229 patients with uterine-confined disease, including 51 with laparoscopy and 178 with laparotomy, the prognosis was not significantly different between the groups (3-year PFS rate, 90.5% vs. 85.5%, p = 0.7; 3-year OS rate, 91.3% vs. 92.5%, p = 0.8). Among the 176 patients with advanced disease, including 24 with laparoscopy and 152 with laparotomy, laparoscopic hysterectomy had a higher PFS rate and OS rate than laparotomic hysterectomy (3-year PFS rate, 74.5% vs. 51.5%, p = 0.01; 3-year OS rate, 92.3% vs. 75.1%, p = 0.03). Conclusions Laparoscopic procedures are not associated with a poorer outcome than laparotomy in patients with advanced endometrial cancer or uterine-confined endometrial cancer. Keywords Endometrial cancer · Laparoscopic hysterectomy · Abdominal hysterectomy
Introduction Laparoscopic hysterectomy for patients with endometrial cancer has been performed worldwide as a minimally invasive surgery for a decade [1–4]. Several studies have shown the feasibility of laparoscopic surgery in light of its promising short-term outcomes, including a low intraoperative * Tomohito Tanaka gyn123@osaka‑med.ac.jp 1
Department of Obstetrics and Gynecology, Osaka Medical College, 2‑7, Daigaku‑machi, Takatsuki, Osaka 569‑8686, Japan
Translational Research Program, Osaka Medical College, Takatsuki, Japan
2
blood loss, short hospital stay and low rate of complications. Large-scale prospective studies have also shown that laparoscopic surgery has similar oncologic outcomes to laparotomy; however, most participants in those studies were
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