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 language | English |
|---|---|
| Pages (from-to) | 894-900 |
| Number of pages | 7 |
| Journal | International Journal of Gynecological Cancer |
| Volume | 24 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2014 |
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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 journal › Article
}
TY - JOUR
T1 - Perioperative and long-term outcomes of laparoscopic, open abdominal, and vaginal surgery for endometrial cancer in patients aged 80 years or older
AU - Bogani, Giorgio
AU - Cromi, Antonella
AU - Uccella, Stefano
AU - Serati, Maurizio
AU - Casarin, Jvan
AU - Pinelli, Ciro
AU - Ghezzi, Fabio
PY - 2014
Y1 - 2014
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.
KW - Elderly
KW - Endometrial cancer
KW - Hysterectomy
KW - Laparoscopy
KW - Staging
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U2 - 10.1097/IGC.0000000000000128
DO - 10.1097/IGC.0000000000000128
M3 - Article
VL - 24
SP - 894
EP - 900
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
SN - 1048-891X
IS - 5
ER -