scholarly journals Does the Type of Surgical Approach and the Use of Uterine Manipulators Influence the Disease-Free Survival and Recurrence Rates in Early-Stage Endometrial Cancer?

2016 ◽  
Vol 26 (9) ◽  
pp. 1722-1726 ◽  
Author(s):  
Josefa Marcos-Sanmartín ◽  
José Antonio López Fernández ◽  
José Sánchez-Payá ◽  
Óscar Cruz Piñero-Sánchez ◽  
María José Román-Sánchez ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Early Stage ◽  
Disease Free Survival ◽  
Laparoscopic Hysterectomy ◽  
Recurrence Rates ◽  
Free Survival ◽  
Laparotomy Group ◽  
Early Stage Endometrial Cancer

ObjectiveThe purpose of this study was to compare the long-term safety, disease-free survival, and recurrence rate of total laparoscopic hysterectomy using uterine manipulator and abdominal hysterectomy in the surgical treatment in early-stage endometrial cancer.Study DesignThis was a cohort study of 147 patients with clinical endometrial cancer (laparoscopic surgery group, 77 women; laparotomy group, 70 women). Data were evaluated and analyzed by intention-to-treat principle, and survival data of stage I endometrial cancer (129 patients; 66 from laparoscopic surgery group and 60 from laparotomy group) were estimated by using the Kaplan-Meier curves.ResultsAfter a follow-up period of 60 months for both laparoscopic surgery and laparotomy groups, no significant difference in the cumulative recurrence rates (7.4% and 13.1%, P = 0.091) and overall survival (97.1% and 95.1%, P = 0.592) was detected between both groups of stage I endometrial cancer. Conversion to laparotomy occurred in 10.4% (8/77) of the laparoscopic procedures. Laparoscopic hysterectomy was associated with less use of pain medication (P = 0.001) and a shorter hospital stay (P < 0.001), but the procedure took longer than laparotomic hysterectomy (P < 0.001). The proportion of patients with intraoperative and long-term complications was not significantly different between both groups. The use of uterine manipulators did not have increased recurrence rate in patients treated with laparoscopic approach.ConclusionsThe laparoscopic surgery approach to early-stage endometrial cancer using uterine manipulators is as safe and effective as the laparotomic approach.

scholarly journals Laparoscopic surgery for early-stage endometrial cancer: Perioperative outcomes and long-term prognosis

2015 ◽  
Vol 31 (1) ◽  
pp. 120-125
Author(s):  
Ayako Nozaki ◽  
Tetsuji Odagiri ◽  
Maki Kanno ◽  
Kenrokuro Mitsube ◽  
Yu Furuta ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Early Stage ◽  
Perioperative Outcomes ◽  
Long Term Prognosis ◽  
Early Stage Endometrial Cancer

Chemotherapy as Adjuvant Treatment for Early Stage Endometrial Cancer With High Intermediate Risk Factors

2018 ◽  
Vol 28 (7) ◽  
pp. 1285-1289
Author(s):  
Min Gao ◽  
Naiyi Zhang ◽  
Nan Song ◽  
Hong Zheng ◽  
Xin Yan ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Disease Free Survival ◽  
Intermediate Risk ◽  
Free Survival ◽  
Platinum Based Chemotherapy ◽  
Disease Free ◽  
Early Stage Endometrial Cancer

ObjectiveThe aim of this study was to explore the role of chemotherapy as adjuvant treatment for early-stage endometrial cancer (EC) with high-intermediate-risk (HIR) factors.MethodsA prospective study of patients with early-stage EC with HIR factors for recurrence was performed between 2006 and 2014. A total of 96 patients were enrolled, and 50 patients received 3 cycles of platinum-based chemotherapy after surgery. Five-year disease-free survival and overall survival were evaluated.ResultsA total of 11 (11.5%) of the 96 patients had recurrence, with a median recurrent time of 15.4 months. Of these 11 patients with recurrence, 2 received adjuvant chemotherapy after surgery, whereas 9 did not receive any treatment. Patients without adjuvant chemotherapy exhibited a significantly higher recurrence rate than those with adjuvant chemotherapy (19.6% vs 4%; P = 0.024). Meanwhile, patients with adjuvant chemotherapy had significantly higher 5-year disease-free survival compared with the control group (92.1% vs 70.0%, P = 0.024).ConclusionsChemotherapy is feasible and safe as adjuvant treatment for early-stage EC with HIR factors. Three cycles of platinum-based chemotherapy are sufficient for reducing the risk of recurrence. Further, large sample randomized studies are needed to confirm these results.

scholarly journals EP-1495 Improved Disease-Free Survival with Radiotherapy in Early Stage Endometrial Cancer: 10­year outcome

2019 ◽  
Vol 133 ◽  
pp. S810
Author(s):  
S. Aytac Arslan ◽  
I.P. Aral ◽  
G. Altinisik Inan ◽  
Y. Tezcan ◽  
F. Avsar ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free ◽  
Early Stage Endometrial Cancer

scholarly journals Oncological outcomes of laparoscopic radical hysterectomy versus radical abdominal hysterectomy in patients with early-stage cervical cancer: a multicenter analysis

2021 ◽  
pp. ijgc-2020-002086
Author(s):  
Juliana Rodriguez ◽  
Jose Alejandro Rauh-Hain ◽  
James Saenz ◽  
David Ortiz Isla ◽  
Gabriel Jaime Rendon Pereira ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Disease Free Survival ◽  
Free Survival ◽  
Laparoscopic Radical Hysterectomy ◽  
Oncological Outcomes ◽  
Early Stage Cervical Cancer ◽  
Laparotomy Group ◽  
Disease Free

IntroductionRecent evidence has shown adverse oncological outcomes when minimally invasive surgery is used in early-stage cervical cancer. The objective of this study was to compare disease-free survival in patients that had undergone radical hysterectomy and pelvic lymphadenectomy, either by laparoscopy or laparotomy.MethodsWe performed a multicenter, retrospective cohort study of patients with cervical cancer stage IA1 with lymph-vascular invasion, IA2, and IB1 (FIGO 2009 classification), between January 1, 2006 to December 31, 2017, at seven cancer centers from six countries. We included squamous, adenocarcinoma, and adenosquamous histologies. We used an inverse probability of treatment weighting based on propensity score to construct a weighted cohort of women, including predictor variables selected a priori with the possibility of confounding the relationship between the surgical approach and survival. We estimated the HR for all-cause mortality after radical hysterectomy with weighted Cox proportional hazard models.ResultsA total of 1379 patients were included in the final analysis, with 681 (49.4%) operated by laparoscopy and 698 (50.6%) by laparotomy. There were no differences regarding the surgical approach in the rates of positive vaginal margins, deep stromal invasion, and lymphovascular space invasion. Median follow-up was 52.1 months (range, 0.8–201.2) in the laparoscopic group and 52.6 months (range, 0.4–166.6) in the laparotomy group. Women who underwent laparoscopic radical hysterectomy had a lower rate of disease-free survival compared with the laparotomy group (4-year rate, 88.7% vs 93.0%; HR for recurrence or death from cervical cancer 1.64; 95% CI 1.09–2.46; P=0.02). In sensitivity analyzes, after adjustment for adjuvant treatment, radical hysterectomy by laparoscopy compared with laparotomy was associated with increased hazards of recurrence or death from cervical cancer (HR 1.7; 95% CI 1.13 to 2.57; P=0.01) and death for any cause (HR 2.14; 95% CI 1.05–4.37; P=0.03).ConclusionIn this retrospective multicenter study, laparoscopy was associated with worse disease-free survival, compared to laparotomy.

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