Endometrial cancer: similar survival with minimally invasive vs open surgery

  • Tanaka T & al.
  • Int J Clin Oncol
  • 9 Jul 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Laparoscopic hysterectomy vs abdominal hysterectomy yields similar survival in patients with low-risk and uterine-confined endometrial cancer.
  • In patients with advanced disease, laparoscopy is associated with improved survival.

Why this matters

  • Long-term outcomes of laparoscopic hysterectomy vs open surgery are unclear.

Study design

  • 883 patients with endometrial cancer who underwent laparoscopic or abdominal hysterectomy were categorized into 3 groups:
    • Low-risk disease (n=478).
    • Uterine-confined disease (n=229).
    • Advanced disease (n=176).
  • Funding: None.

Key results

  • Median follow-up was 31 months in the laparoscopy group and 69 months in the abdominal hysterectomy group.
  • Laparoscopy vs laparotomy showed no significant difference in PFS and OS at 3 years.
    • Low-risk disease:
      • PFS: 97.4% vs 97.1% (P=.8).
      • OS: 98.6% vs 98.3% (P=.9).
    • Uterine-confined disease:
      • PFS: 90.5% vs 85.5% (P=.7).
      • OS: 91.3% vs 92.5% (P=.8).
  • In patients with advanced disease, laparoscopic hysterectomy was associated with:
  • Higher 3-year PFS: 74.5% vs 51.5%.
    • Relative risk: 0.33 (P=.02). 
  • Higher OS: 92.3% vs 75.1% (P=.03).

Limitations

  • Small retrospective study.