Introduction/Background According to Bulletin of National Cancer Registry of Ukraine vol. 20, 2017–2018 endometrial cancer (EC) is the third most commonly occurring cancer in women in Ukraine, it constituted 9.4% (age-standardised rate is 21.4 per 100,000), but 5-year survival rate is lower than in high-income countries. This study aimed to find the best approach for treatment of endometrioid EC in women with obesity III-IV degree to balance appropriate extent of surgery and risk of intra- and postoperative complications.
Methodology The study involved patients with endometrioid EC T1aN0M0 G1 - G2 and obesity III-IV: 107 of them underwent total abdominal hysterectomy + bilateral salpingo-oophoreectomy (TAH+BSO), other 23 patients were treated by laparoscopically assisted vaginal hysterectomy (LAVH). The criteria for accrual had included CT, MRI and then intraoperative evidence allowing to omit lymphadenectomy (selective lymphadenectomy paradigm).
Results Women of both subsets matched by age (respectively 60.9 and 62.4 years). TAH+BSO time constituted 154 min, blood loss was 320 ml, intraoperative complications occurred in 8 cases (7.5%), postoperative - 2 (8.7%), duration of stay in hospital reached 16.9 days. LAVH time was slightly shorter (135 min), blood loss was significantly reduced (240 ml) as well as the rate of intra- and postoperative complications: respectively 2 (8.7%) and 2 (8.7%), time of hospital stay was 2.7 days. Both groups matched by tumour grading: TAH+BSO - G1 in 80 pts (74.8%), G2 - 27 (25.2%); LAVT - 17 (73.9%) and 6 (26.1%) respectively. Throughout 4.5 years of follow-up there were 5 recurrences (4.67%) in TAH+BSO group and 1 recurrence in LAVT group (4.35%).
Conclusion LAVH as a treatment for endometrioid EC T1aN0M0 G1 - G2 and obesity III-IV with preoperative and intraoperative evidence against lymphadenectomy is safe and gains benefits, namely: reduction of procedure’s time, blood loss, intra- and postoperative complications’ rate and duration of hospital stay.
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.