Laparoscopic versus open surgery for endometrial cancer

A minimum 3-year follow-up study

Fabio Ghezzi, Antonella Cromi, Stefano Uccella, Gabriele Siesto, Silvia Giudici, Maurizio Serati, Massimo Franchi

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: The paucity of long-term oncologic results published in the literature still prevents the scientific community from cementing the place of laparoscopy as the procedure of choice for managing endometrial cancer. We present the outcomes of consecutive patients with endometrial cancer managed laparoscopically with >3-year follow-up. Methods: Data from 117 consecutive women undergoing surgery for treatment of a clinical stage I endometrial cancer and who achieved at least 3-year follow-up were prospectively analyzed. These cases were compared with a historical cohort of 122 consecutive patients with endometrial cancer who had undergone surgery through laparotomy. Results: The laparoscopy and laparotomy groups were similar with regard to baseline patient characteristics, surgical stage, proportion of tumors with unfavorable histology and high grade, as well as patterns of adjuvant therapy. The median (range) follow-up of surviving patients was 52 (36-84) months in the laparoscopic cohort and 80 (36-151) months in the laparotomy cohort. Women who underwent laparoscopy and those who underwent laparotomy had similar 3-year recurrence-free survival rates (91.4% vs. 88.5%, P = 0.52), as well as similar 3-year overall survival rates (94.0% vs. 93.4%, P = 1.0). Multivariate analysis showed that advanced surgical stage, unfavorable histology, and patient age >65 years significantly affect survival, regardless of the surgical approach used. Conclusions: Cancer control in women with endometrial cancer does not appear to be worsened by laparoscopic surgery. In the absence of level I evidence to establish long-term recurrence and survival equivalence, analysis of series as they mature is crucial to fully evaluate disease control afforded by laparoscopy.

Original languageEnglish
Pages (from-to)271-278
Number of pages8
JournalAnnals of Surgical Oncology
Volume17
Issue number1
DOIs
Publication statusPublished - Jan 2010

Fingerprint

Endometrial Neoplasms
Laparoscopy
Laparotomy
Histology
Survival Rate
Recurrence
Survival Analysis
Neoplasms
Multivariate Analysis
Survival
Therapeutics

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Laparoscopic versus open surgery for endometrial cancer : A minimum 3-year follow-up study. / Ghezzi, Fabio; Cromi, Antonella; Uccella, Stefano; Siesto, Gabriele; Giudici, Silvia; Serati, Maurizio; Franchi, Massimo.

In: Annals of Surgical Oncology, Vol. 17, No. 1, 01.2010, p. 271-278.

Research output: Contribution to journalArticle

Ghezzi, Fabio ; Cromi, Antonella ; Uccella, Stefano ; Siesto, Gabriele ; Giudici, Silvia ; Serati, Maurizio ; Franchi, Massimo. / Laparoscopic versus open surgery for endometrial cancer : A minimum 3-year follow-up study. In: Annals of Surgical Oncology. 2010 ; Vol. 17, No. 1. pp. 271-278.
@article{0127f497fb7944d381daf5c30684230e,
title = "Laparoscopic versus open surgery for endometrial cancer: A minimum 3-year follow-up study",
abstract = "Background: The paucity of long-term oncologic results published in the literature still prevents the scientific community from cementing the place of laparoscopy as the procedure of choice for managing endometrial cancer. We present the outcomes of consecutive patients with endometrial cancer managed laparoscopically with >3-year follow-up. Methods: Data from 117 consecutive women undergoing surgery for treatment of a clinical stage I endometrial cancer and who achieved at least 3-year follow-up were prospectively analyzed. These cases were compared with a historical cohort of 122 consecutive patients with endometrial cancer who had undergone surgery through laparotomy. Results: The laparoscopy and laparotomy groups were similar with regard to baseline patient characteristics, surgical stage, proportion of tumors with unfavorable histology and high grade, as well as patterns of adjuvant therapy. The median (range) follow-up of surviving patients was 52 (36-84) months in the laparoscopic cohort and 80 (36-151) months in the laparotomy cohort. Women who underwent laparoscopy and those who underwent laparotomy had similar 3-year recurrence-free survival rates (91.4{\%} vs. 88.5{\%}, P = 0.52), as well as similar 3-year overall survival rates (94.0{\%} vs. 93.4{\%}, P = 1.0). Multivariate analysis showed that advanced surgical stage, unfavorable histology, and patient age >65 years significantly affect survival, regardless of the surgical approach used. Conclusions: Cancer control in women with endometrial cancer does not appear to be worsened by laparoscopic surgery. In the absence of level I evidence to establish long-term recurrence and survival equivalence, analysis of series as they mature is crucial to fully evaluate disease control afforded by laparoscopy.",
author = "Fabio Ghezzi and Antonella Cromi and Stefano Uccella and Gabriele Siesto and Silvia Giudici and Maurizio Serati and Massimo Franchi",
year = "2010",
month = "1",
doi = "10.1245/s10434-009-0720-1",
language = "English",
volume = "17",
pages = "271--278",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "1",

}

TY - JOUR

T1 - Laparoscopic versus open surgery for endometrial cancer

T2 - A minimum 3-year follow-up study

AU - Ghezzi, Fabio

AU - Cromi, Antonella

AU - Uccella, Stefano

AU - Siesto, Gabriele

AU - Giudici, Silvia

AU - Serati, Maurizio

AU - Franchi, Massimo

PY - 2010/1

Y1 - 2010/1

N2 - Background: The paucity of long-term oncologic results published in the literature still prevents the scientific community from cementing the place of laparoscopy as the procedure of choice for managing endometrial cancer. We present the outcomes of consecutive patients with endometrial cancer managed laparoscopically with >3-year follow-up. Methods: Data from 117 consecutive women undergoing surgery for treatment of a clinical stage I endometrial cancer and who achieved at least 3-year follow-up were prospectively analyzed. These cases were compared with a historical cohort of 122 consecutive patients with endometrial cancer who had undergone surgery through laparotomy. Results: The laparoscopy and laparotomy groups were similar with regard to baseline patient characteristics, surgical stage, proportion of tumors with unfavorable histology and high grade, as well as patterns of adjuvant therapy. The median (range) follow-up of surviving patients was 52 (36-84) months in the laparoscopic cohort and 80 (36-151) months in the laparotomy cohort. Women who underwent laparoscopy and those who underwent laparotomy had similar 3-year recurrence-free survival rates (91.4% vs. 88.5%, P = 0.52), as well as similar 3-year overall survival rates (94.0% vs. 93.4%, P = 1.0). Multivariate analysis showed that advanced surgical stage, unfavorable histology, and patient age >65 years significantly affect survival, regardless of the surgical approach used. Conclusions: Cancer control in women with endometrial cancer does not appear to be worsened by laparoscopic surgery. In the absence of level I evidence to establish long-term recurrence and survival equivalence, analysis of series as they mature is crucial to fully evaluate disease control afforded by laparoscopy.

AB - Background: The paucity of long-term oncologic results published in the literature still prevents the scientific community from cementing the place of laparoscopy as the procedure of choice for managing endometrial cancer. We present the outcomes of consecutive patients with endometrial cancer managed laparoscopically with >3-year follow-up. Methods: Data from 117 consecutive women undergoing surgery for treatment of a clinical stage I endometrial cancer and who achieved at least 3-year follow-up were prospectively analyzed. These cases were compared with a historical cohort of 122 consecutive patients with endometrial cancer who had undergone surgery through laparotomy. Results: The laparoscopy and laparotomy groups were similar with regard to baseline patient characteristics, surgical stage, proportion of tumors with unfavorable histology and high grade, as well as patterns of adjuvant therapy. The median (range) follow-up of surviving patients was 52 (36-84) months in the laparoscopic cohort and 80 (36-151) months in the laparotomy cohort. Women who underwent laparoscopy and those who underwent laparotomy had similar 3-year recurrence-free survival rates (91.4% vs. 88.5%, P = 0.52), as well as similar 3-year overall survival rates (94.0% vs. 93.4%, P = 1.0). Multivariate analysis showed that advanced surgical stage, unfavorable histology, and patient age >65 years significantly affect survival, regardless of the surgical approach used. Conclusions: Cancer control in women with endometrial cancer does not appear to be worsened by laparoscopic surgery. In the absence of level I evidence to establish long-term recurrence and survival equivalence, analysis of series as they mature is crucial to fully evaluate disease control afforded by laparoscopy.

UR - http://www.scopus.com/inward/record.url?scp=74649086026&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=74649086026&partnerID=8YFLogxK

U2 - 10.1245/s10434-009-0720-1

DO - 10.1245/s10434-009-0720-1

M3 - Article

VL - 17

SP - 271

EP - 278

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 1

ER -