Minimally Invasive Surgery in High-Grade Endometrial Carcinoma and Risk for Local Recurrence: An Israeli Gynecology Oncology Group Study

ObjectiveTo investigate the prevalence of positive peritoneal cytology and lymph-vascular invasion by surgical approach among patients with early stage endometrioid endometrial carcinoma undergoing hysterectomy.MethodsThe National Cancer Database was accessed and patients with FIGO stage I endometrioid endometrial carcinoma (with no history of another tumor diagnosed) who underwent simple hysterectomy (open or minimally invasive) between January 2010 and December 2015 and had available data on the presence of lymph-vascular invasion and/or status of peritoneal cytology were selected for further analysis. The impact of a surgical approach on the odds of lymph-vascular invasion and positive peritoneal cytology was calculated after controlling for tumor grade, size, and depth of myometrial invasion.ResultsA total of 74 732 patients who met the inclusion criteria were identified. The rate of minimally invasive hysterectomy was 75.7%. Data on peritoneal cytology status and lymph-vascular invasion were available for 50 185 and 71 641 patients, respectively. A higher proportion of patients who had minimally invasive hysterectomy had positive peritoneal cytology (4.4% vs 2.3%, p<0.001), and presence of lymph-vascular invasion (10.4% vs 9.2%, p<0.001). After controlling for tumor size, tumor grade, and disease substage, the performance of minimally invasive surgery was associated with higher odds of positive peritoneal cytology (OR 2.08, 95% CI 1.83 to 2.37) and presence of lymph-vascular invasion (OR 1.33, 95% CI 1.25 to 1.41). After controlling for confounders there was no difference in survival between open and minimally invasive surgery groups (HR 0.93, 95% CI 0.85 to 1.004).ConclusionsMinimally invasive surgery may be associated with a higher incidence of positive peritoneal cytology and lymph-vascular invasion among patients with early stage endometrioid endometrial cancer. There was no difference in overall survival between patients who had laparotomy or minimally invasive surgery.

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Minimizing Minimally Invasive Surgery for Endometrial Carcinoma

American Society of Clinical Oncology Educational Book ◽

10.14694/edbk_100009 ◽

2017 ◽

Vol 37 ◽

pp. 23-28

Author(s):

Melissa K. Frey ◽

Stephanie V. Blank ◽

John P. Curtin

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Endometrial Carcinoma ◽

Invasive Surgery

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Comparison of Minimally Invasive Surgery versus Laparotomy for Surgical Staging of Endometrial Carcinoma: A Retrospective Study

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i1.29613 ◽

2020 ◽

Vol 5 (1) ◽

pp. 916-920

Author(s):

Mona Priyadarshini ◽

Rani Akhil Bhat

Keyword(s):

Endometrial Cancer ◽

Minimally Invasive Surgery ◽

Blood Loss ◽

Minimally Invasive ◽

Hospital Stay ◽

Endometrial Carcinoma ◽

Invasive Surgery ◽

Surgical Staging ◽

Duration Of Hospital Stay ◽

Significant Difference

Introduction: Endometrial carcinoma is one of the commonest gynaecological cancer in developed countries as well as developing countries. The mainstay of initial treatment of endometrial carcinoma is surgical staging which may be performed by either the conventional abdominal approach or by minimally invasive route i.e. laparoscopic or robotic. Objectives: The purpose of this study was to compare and evaluate the surgical staging, safety and clinical benefits of minimally invasive surgeries versus. laparotomy in patients with endometrial cancer. Methodology: We retrospectively analyzed 105 patients with endometrial cancer over a period of five years and compared the outcome of total hysterectomy with pelvic and para-aortic lymphadenectomy by abdominal, laparoscopic approach or robotic-assisted surgery. Comparison was done with respect to operative time, blood loss, number of lymph nodes retrieved, length of hospital stay, intraoperative and postoperative complications. The data were analyzed using paired “t”- test / Wilcoxon signed rank test ,χ2 - test, Pearson correlation coefficient “r” whenever found suitable. P value of less than 0.05 was considered as statistically significant. Result: There was no statistically significant difference seen in the baseline characteristics like age and BMI between the two groups. The laparotomies were done in a shorter time than the minimally invasive approach (p<0.001). The amount of blood loss (p=0.002), and the duration of hospital stay (p<0.001) was significantly less in the minimally invasive surgery group than the laparotomies. Not much difference in the lymph node retrieval was observed between the two arms (p=0.614). The number of complications were almost similar in both the groups. Conclusion: Minimally invasive surgery for surgical staging of endometrial carcinoma is feasible and effective than laparotomy. The amount of blood loss and duration of hospital stay is seen much lesser with MIS than laparotomy.

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