Laparoscopic Versus Open Abdominal Radical Hysterectomy for Patients with Endometrial Cancer Involving Cervix
Abstract BACKGROUND: Data on the survival outcome between laparoscopic and open abdominal radical hysterectomy is limited in patients with endometrial cancer involving cervix.METHODS: We performed a retrospective 1:1 matched observational study in patients who had their cervix involved by endometrial cancer during the 2010–2018 period in Beijing Obstetrics and Gynecology Hospital in China. All enrolled patients underwent cancer-directed radical hysterectomy through laparoscopic approach or open abdominal surgery and followed until 3 years after the surgery. The primary outcome was the rates of disease-free survival and overall survival.RESULTS: A total of 142 patients were included in the study, 54 patients received laparoscopic surgery and 54 of the remaining 88 patients who received open surgery were selected as control. Overall, the median follow-up duration was 54.22 ± 31.14 months (95%CI: 48.71–59.89 months). There was no difference on the baseline information between two groups, including ages, rates of histologic subtypes, rates of deep myometrial invasion, rates of lymph-node involvement, and postoperative stage. There was no significant difference between the three-year disease-free rates between two groups (3-year rate, 94.3% vs. 92.2%; hazard ratio, 1.36; 95% CI, 0.40 to 4.61). The 3-years rate of overall survival in patients of the laparoscopic group was comparable to patients in the open surgery group (3-year rate, 89.87% vs. 92.14%; hazard ratio for death from any cause, 1.87; 95% CI, 0.60 to5.86).CONCLUSIONS: This study revealed that laparoscopic approach surgery was not associated with shorter disease-free survival and overall survival than open abdominal radical hysterectomy in patients with endometrial cancer involving cervix.