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Laparoscopic Versus Abdominal Approach to Endometrial Cancer: A 10-Year Retrospective Multicenter Analysis
  1. Stefano Palomba, MD*,
  2. Fabio Ghezzi, MD,
  3. Angela Falbo, MD, PhD*,
  4. Vincenzo Dario Mandato, MD, PhD,
  5. Gianluca Annunziata, MD§,
  6. Emilio Lucia, MD,
  7. Antonella Cromi, MD,
  8. Martino Abrate, MD,
  9. Giovanni Battista La Sala, MD,
  10. Giorgio Giorda, MD,
  11. Fulvio Zullo, MD§ and
  12. Massimo Franchi, MD,
  1. * Department of Obstetrics and Gynecology, University “Magna Graecia” of Catanzaro, Catanzaro;
  2. Department of Obstetrics and Gynecology, University of Insubria, Varese;
  3. Department of Obstetrics and Gynecology, Arcispedale “Santa Maria Nuova,” Reggio Emilia;
  4. § Gynecologic Oncology Unit, Cancer Center of Excellence “Tommaso Campanella” of Germaneto, Catanzaro;
  5. Gynecologic Oncology Unit, National Cancer Institute of Aviano, Aviano (PN); and
  6. Department of Obstetrics and Gynecology, University of Verona, Verona; Italy.
  1. Address correspondence and reprint requests to Stefano Palomba, MD, Via T. Campanella 182/I- 88100 Catanzaro, Italy. E-mail: stefanopalomba{at}tin.it.

Abstract

Objective The objective of this study was to give a reality-based picture of the use of laparoscopic surgery for staging endometrial cancer patients out of the experimental setting.

Methods Consecutive data of patients with endometrial cancer who underwent laparoscopic or abdominal surgical staging in 6 Italian centers were recorded. Baseline patients and tumors characteristics, surgery performed, and safety data were collected and analyzed.

Results A total of 1012 subjects (403 and 609 treated by laparoscopy and laparotomy, respectively) who received surgical stadiation for endometrial cancer were included in the final analysis. The laparoscopic approach to endometrial cancer was more commonly performed in younger and nonobese patients who had received less previous surgeries, whereas the abdominal approach was preferred for the advanced stages and rare histotypes. Irrespectively to stage, the operative time was higher for the laparoscopy than laparotomy, whereas blood loss and postoperative complications were lower in the laparoscopy group than in the laparotomy group. No difference between surgical approaches was observed in complication rates in stage I endometrial cancers, whereas they were worst in higher stages. The site, but not the incidence, of recurrences differed only for advanced stage endometrial cancers. No differences in overall, disease-free, and cancer-related survival rates were also observed.

Conclusions In the clinical practice, heterogeneous criteria are adopted to recur to laparoscopy for staging endometrial cancer. The safety and the feasibility of the laparoscopy are confirmed for stage I endometrial cancers, whereas they appear suboptimal for the advanced stages.

  • Endometrial cancer
  • Laparoscopy
  • Laparotomy
  • Surgery
  • Uterine cancer

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Footnotes

  • The authors declare that there are no conflicts of interest.

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