Introduction/Background Laparoscopic hysterectomy has been proven to be a safe surgical procedure and is globally accepted as the standard treatment for early-stage endometrial cancer, despite insufficient data on long-term survival. Aim was to provide the five-years outcomes of a randomised Dutch trial on total laparoscopic hysterectomy (TLH) versus total abdominal hysterectomy (TAH) in early-stage low-risk endometrial cancer.

Methodology Follow-up of a multi-centre, randomised controlled trial on TLH versus TAH without routine lymphadenectomy. A total of 279 women with stage I endometrial cancer were enrolled between 2007–2009 in a 2:1 randomisation to undergo either TLH (n=185) or TAH (n=94). Primary outcome was disease-free survival. Secondary outcomes were primary site of recurrence, overall and disease-specific survival. The Kaplan-Meier survival curves and Cox proportional hazard ratios were applied.

Results Follow-up data of 253/279 patients are available. At a median follow-up time of 5.0 years, disease-free survival was 90.4% after TLH and 83.3% after TAH, HR 0.68 (95% CI 0.31–1.49). There were no port-site metastases and local recurrence rates were comparable. After adjustment for the covariates, overall survival outcomes were comparable between groups HR 0.64 (95% CI 0.33–1.26). Disease-specific survival was comparable between both groups.

Conclusion This is the first study reporting on survival among women with early-stage endometrial cancer randomised to TLH or TAH, without routine lymphadenectomy. No significant differences were found in disease-free, overall and disease-specific survival five-years postoperatively. This supports the widespread use of laparoscopic hysterectomy as primary treatment procedure for early-stage, low-grade endometrial cancer.

Disclosures None.