Perioperative and long-term outcomes of laparoscopic, open abdominal, and vaginal surgery for endometrial cancer in patients aged 80 years or older

Giorgio Bogani, Antonella Cromi, Stefano Uccella, Maurizio Serati, Jvan Casarin, Ciro Pinelli, Fabio Ghezzi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: This study was undertaken to evaluate the safety, feasibility, and the long-term effectiveness of laparoscopy in endometrial cancer patients aged 80 years or older. Methods: Data of consecutive patients aged 80 years and older undergoing laparoscopic, open abdominal, and vaginal approaches were compared. Postoperative complications were graded per the Accordion Severity Classification. Survival outcomes within the first 5 years were analyzed using the Kaplan-Meier method. Results: Among 726 patients, 63 (9%) were aged 80 years and older. Laparoscopic, open abdominal, and vaginal surgery were performed in 22 (35%), 25 (40%), and 16 (25%) cases, respectively. All laparoscopic procedures were completed laparoscopically, whereas a conversion fromvaginal to open procedure occurred (0%vs 6%;P= 0.42).Patients undergoing laparoscopy experienced similar operative time (P > 0.05), lower blood loss (P <0.05), and shorter hospital stay (P <0.05) than patients undergoing open and vaginal surgery. No intraoperative complications were recorded. Laparoscopy is related to a lower rate of postoperative complications (P = 0.09) and Accordion grade greater than or equal to 2 complications (P = 0.05) in comparison to open abdominal and vaginal surgery. The route of surgical approaches did not influence the 5-year disease-free (P = 0.97, log-rank test) and overall (P = 0.94, log-rank test) survivals. Conclusions: Laparoscopy seems to represent a safe and effective treatment of endometrial cancer in women aged 80 years or older. Our data suggest that in elderly women, laparoscopic surgery improves perioperative outcomes compared with open and vaginal approaches without compromising long-term survival.

Original languageEnglish
Pages (from-to)894-900
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number5
DOIs
Publication statusPublished - 2014

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Endometrial Neoplasms
Laparoscopy
Survival
Conversion to Open Surgery
Intraoperative Complications
Operative Time
Length of Stay
Safety
Therapeutics

Keywords

  • Elderly
  • Endometrial cancer
  • Hysterectomy
  • Laparoscopy
  • Staging

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology
  • Medicine(all)

Cite this

Perioperative and long-term outcomes of laparoscopic, open abdominal, and vaginal surgery for endometrial cancer in patients aged 80 years or older. / Bogani, Giorgio; Cromi, Antonella; Uccella, Stefano; Serati, Maurizio; Casarin, Jvan; Pinelli, Ciro; Ghezzi, Fabio.

In: International Journal of Gynecological Cancer, Vol. 24, No. 5, 2014, p. 894-900.

Research output: Contribution to journalArticle

Bogani, Giorgio ; Cromi, Antonella ; Uccella, Stefano ; Serati, Maurizio ; Casarin, Jvan ; Pinelli, Ciro ; Ghezzi, Fabio. / Perioperative and long-term outcomes of laparoscopic, open abdominal, and vaginal surgery for endometrial cancer in patients aged 80 years or older. In: International Journal of Gynecological Cancer. 2014 ; Vol. 24, No. 5. pp. 894-900.
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AU - Serati, Maurizio

AU - Casarin, Jvan

AU - Pinelli, Ciro

AU - Ghezzi, Fabio

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N2 - Objective: This study was undertaken to evaluate the safety, feasibility, and the long-term effectiveness of laparoscopy in endometrial cancer patients aged 80 years or older. Methods: Data of consecutive patients aged 80 years and older undergoing laparoscopic, open abdominal, and vaginal approaches were compared. Postoperative complications were graded per the Accordion Severity Classification. Survival outcomes within the first 5 years were analyzed using the Kaplan-Meier method. Results: Among 726 patients, 63 (9%) were aged 80 years and older. Laparoscopic, open abdominal, and vaginal surgery were performed in 22 (35%), 25 (40%), and 16 (25%) cases, respectively. All laparoscopic procedures were completed laparoscopically, whereas a conversion fromvaginal to open procedure occurred (0%vs 6%;P= 0.42).Patients undergoing laparoscopy experienced similar operative time (P > 0.05), lower blood loss (P <0.05), and shorter hospital stay (P <0.05) than patients undergoing open and vaginal surgery. No intraoperative complications were recorded. Laparoscopy is related to a lower rate of postoperative complications (P = 0.09) and Accordion grade greater than or equal to 2 complications (P = 0.05) in comparison to open abdominal and vaginal surgery. The route of surgical approaches did not influence the 5-year disease-free (P = 0.97, log-rank test) and overall (P = 0.94, log-rank test) survivals. Conclusions: Laparoscopy seems to represent a safe and effective treatment of endometrial cancer in women aged 80 years or older. Our data suggest that in elderly women, laparoscopic surgery improves perioperative outcomes compared with open and vaginal approaches without compromising long-term survival.

AB - Objective: This study was undertaken to evaluate the safety, feasibility, and the long-term effectiveness of laparoscopy in endometrial cancer patients aged 80 years or older. Methods: Data of consecutive patients aged 80 years and older undergoing laparoscopic, open abdominal, and vaginal approaches were compared. Postoperative complications were graded per the Accordion Severity Classification. Survival outcomes within the first 5 years were analyzed using the Kaplan-Meier method. Results: Among 726 patients, 63 (9%) were aged 80 years and older. Laparoscopic, open abdominal, and vaginal surgery were performed in 22 (35%), 25 (40%), and 16 (25%) cases, respectively. All laparoscopic procedures were completed laparoscopically, whereas a conversion fromvaginal to open procedure occurred (0%vs 6%;P= 0.42).Patients undergoing laparoscopy experienced similar operative time (P > 0.05), lower blood loss (P <0.05), and shorter hospital stay (P <0.05) than patients undergoing open and vaginal surgery. No intraoperative complications were recorded. Laparoscopy is related to a lower rate of postoperative complications (P = 0.09) and Accordion grade greater than or equal to 2 complications (P = 0.05) in comparison to open abdominal and vaginal surgery. The route of surgical approaches did not influence the 5-year disease-free (P = 0.97, log-rank test) and overall (P = 0.94, log-rank test) survivals. Conclusions: Laparoscopy seems to represent a safe and effective treatment of endometrial cancer in women aged 80 years or older. Our data suggest that in elderly women, laparoscopic surgery improves perioperative outcomes compared with open and vaginal approaches without compromising long-term survival.

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KW - Endometrial cancer

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KW - Staging

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