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157 Laparoscopic approach to comprehensive surgical staging for clinical stage I endometrial cancer: an institutional review of operative outcomes, costs and its clinical implications
  1. G Facun,
  2. R Sicam and
  3. D Benavides
  1. Philippine General Hospital, Philippines


Objectives The absence of local oncologic results utilizing laparoscopic surgery for early stage endometrial cancer prevents its adoption as procedure of choice in the Philippines. The purpose of this study was to determine the clinical profile, operative outcomes and costs of undergoing laparoscopic surgery for clinical stage I endometrial cancer.

Methodology Data from 28 patients who underwent TLHBSO, PFC, LND for presumed stage I endometrial cancer were collected retrospectively from May 2017 to May 2019 in a tertiary institution.

Results Mean age of the patients was 46.7 (range, 25 to 71). Risk factors included obesity (53.5%), nulliparity (46.4%), diabetes mellitus (14.3%), primary infertility (14.3%), PCOS, (7.1%) and dyslipidemia (3.6%). None of the cases were converted to laparotomy, one necessitated mini-laparotomy to deliver the uterine specimen. Median length of operations was 236 minutes and 281 minutes depending on whether para-aortic lymphadenectomy was included. Complications include blood transfusion (3), vaginal vault dehiscence (1) and lymphocyst formation (1). Mean hospital stay was 7 days. Blood loss was minimal (217.3 ± 171.4 mL). Two out of the 28 cases have stage III disease intra-operatively. Median follow up was 13.5 months. Sixteen subjects (57%) had no evidence of disease on follow up while 2 (7%) already died of disease. The presence of LVSI and tumor size ≥ 2 cm were factors identified for progression. Average hospital cost was $1,137.15 (range, $336.47 to $2,386.98).

Conclusion Laparoscopic surgery is a safe and viable surgical option for carefully selected clinical stage 1 endometrial cancer patients.

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