Abstract
Objective: Older age is a relevant risk factor for developing endometrial cancer (EC) and has been traditionally regarded as a relative contraindication to laparoscopy. Our aim was to analyze the safety and effectiveness of laparoscopic staging in older women with EC. Methods: Consecutive women aged 75 years or older who underwent laparoscopic staging for EC between May 2002 and October 2012 were compared with consecutive women aged 75 years or older who underwent abdominal staging before the adoption of the laparoscopic approach in our institution. Postoperative complications were graded according to the Accordion Severity Grading System. Results: Fifty-nine women aged 75 years or older who underwent laparoscopy were compared with a cohort of 66 women aged 75 years or older who underwent open staging before the incorporation of laparoscopy. Demographic and disease characteristics, as well as the Charlson comorbidity index, were balanced between groups. Women who underwent laparoscopy had similar operative time (P = 0.14), lower blood loss (P = 0.005), and shorter length of stay (P <0.001) in comparison with women who underwent open surgical operation. Overall, women who underwent laparoscopy experienced less postoperative complications than women in the control group (P <0.001). In addition, focusing only on complications grade 3 or higher, we observed a trend toward decreased complication rates in the laparoscopic group (P = 0.06). No differences in survival outcomes (including time of recurrence, site of recurrence, disease-free survival, and overall survival) were recorded (P > 0.05). Conclusions: Our findings suggest that EC patients older than 75 years may benefit from minimally invasive surgical operation and should not be denied laparoscopy based on mere chronological age.
| Original language | English |
|---|---|
| Pages (from-to) | 945-951 |
| Number of pages | 7 |
| Journal | Menopause |
| Volume | 21 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Elderly
- Endometrial cancer
- Laparoscopy
- Staging
- Survival
ASJC Scopus subject areas
- Obstetrics and Gynaecology
- Medicine(all)
Cite this
Laparoscopic staging in women older than 75 years with early-stage endometrial cancer : Comparison with open surgical operation. / Bogani, Giorgio; Cromi, Antonella; Uccella, Stefano; Serati, Maurizio; Casarin, Jvan; Mariani, Andrea; Ghezzi, Fabio.
In: Menopause, Vol. 21, No. 9, 2014, p. 945-951.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic staging in women older than 75 years with early-stage endometrial cancer
T2 - Comparison with open surgical operation
AU - Bogani, Giorgio
AU - Cromi, Antonella
AU - Uccella, Stefano
AU - Serati, Maurizio
AU - Casarin, Jvan
AU - Mariani, Andrea
AU - Ghezzi, Fabio
PY - 2014
Y1 - 2014
N2 - Objective: Older age is a relevant risk factor for developing endometrial cancer (EC) and has been traditionally regarded as a relative contraindication to laparoscopy. Our aim was to analyze the safety and effectiveness of laparoscopic staging in older women with EC. Methods: Consecutive women aged 75 years or older who underwent laparoscopic staging for EC between May 2002 and October 2012 were compared with consecutive women aged 75 years or older who underwent abdominal staging before the adoption of the laparoscopic approach in our institution. Postoperative complications were graded according to the Accordion Severity Grading System. Results: Fifty-nine women aged 75 years or older who underwent laparoscopy were compared with a cohort of 66 women aged 75 years or older who underwent open staging before the incorporation of laparoscopy. Demographic and disease characteristics, as well as the Charlson comorbidity index, were balanced between groups. Women who underwent laparoscopy had similar operative time (P = 0.14), lower blood loss (P = 0.005), and shorter length of stay (P <0.001) in comparison with women who underwent open surgical operation. Overall, women who underwent laparoscopy experienced less postoperative complications than women in the control group (P <0.001). In addition, focusing only on complications grade 3 or higher, we observed a trend toward decreased complication rates in the laparoscopic group (P = 0.06). No differences in survival outcomes (including time of recurrence, site of recurrence, disease-free survival, and overall survival) were recorded (P > 0.05). Conclusions: Our findings suggest that EC patients older than 75 years may benefit from minimally invasive surgical operation and should not be denied laparoscopy based on mere chronological age.
AB - Objective: Older age is a relevant risk factor for developing endometrial cancer (EC) and has been traditionally regarded as a relative contraindication to laparoscopy. Our aim was to analyze the safety and effectiveness of laparoscopic staging in older women with EC. Methods: Consecutive women aged 75 years or older who underwent laparoscopic staging for EC between May 2002 and October 2012 were compared with consecutive women aged 75 years or older who underwent abdominal staging before the adoption of the laparoscopic approach in our institution. Postoperative complications were graded according to the Accordion Severity Grading System. Results: Fifty-nine women aged 75 years or older who underwent laparoscopy were compared with a cohort of 66 women aged 75 years or older who underwent open staging before the incorporation of laparoscopy. Demographic and disease characteristics, as well as the Charlson comorbidity index, were balanced between groups. Women who underwent laparoscopy had similar operative time (P = 0.14), lower blood loss (P = 0.005), and shorter length of stay (P <0.001) in comparison with women who underwent open surgical operation. Overall, women who underwent laparoscopy experienced less postoperative complications than women in the control group (P <0.001). In addition, focusing only on complications grade 3 or higher, we observed a trend toward decreased complication rates in the laparoscopic group (P = 0.06). No differences in survival outcomes (including time of recurrence, site of recurrence, disease-free survival, and overall survival) were recorded (P > 0.05). Conclusions: Our findings suggest that EC patients older than 75 years may benefit from minimally invasive surgical operation and should not be denied laparoscopy based on mere chronological age.
KW - Elderly
KW - Endometrial cancer
KW - Laparoscopy
KW - Staging
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84906938907&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906938907&partnerID=8YFLogxK
U2 - 10.1097/GME.0000000000000202
DO - 10.1097/GME.0000000000000202
M3 - Article
VL - 21
SP - 945
EP - 951
JO - Menopause
JF - Menopause
SN - 1072-3714
IS - 9
ER -