Introduction/Background Minimally invasive surgery in endometrial cancer has advantages over open surgery in terms of less morbidity, shorter hospitalization and quicker recovery. Many centers have adopted it as first line management for endometrial cancer. Minimally invasive lymphadenectomy is technically demanding and more evidence is required on whether this approach yields comparable oncological outcomes to open surgery. Our aim is to compare the efficacy and survival outcomes of minimally invasive and open pelvic and para-aortic lymph node dissection in early stage endometrial cancer.
Methodology Stage I to II endometrial cancer patients with pelvic and/or para-aortic lymph node dissection performed in Prince of Wales Hospital in Hong Kong from January 2007 to April 2014 were included. Operative records, pathology reports and follow up notes were reviewed retrospectively.
Results A total of 94 endometrial cancer patients with open/ laparoscopic/ robotic pelvic ± para-aortic lymphadenectomy performed were included. Five year follow up was completed in 89 patients (94%). The two groups were comparable in demographics as shown in table 1, except the open group had more stage II disease and larger uterine size. The 5 year disease free survival and 5 year overall survival of the 2 groups were similar. Open surgery was associated with more blood loss (p=0.01) and longer hospital stay (p=0.00), whereas minimally invasive surgery was associated with longer operating time (p=0.00). The number of pelvic/ para-aortic lymph node obtained, surgical complication and lymphedema/lymphocyst formation did not differ significantly. None of the factors such as stage or grade was found to affect the efficacy of minimally invasive pelvic lymph node dissection.
Conclusion Minimally invasive surgery pelvic/ para-aortic lymphadenectomy in early stage endometrial cancer is as effective as open surgery with similar survival, complication rate and number of lymph nodes obtained. It has advantages of shorter hospital stay and less blood loss.
Disclosure Nothing to disclose.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.