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OP012/#257 Minimally invasive surgery is associated with an increased risk for local recurrence in high-grade endometrial carcinoma
  1. G Levin1,
  2. L Kogan2,
  3. L Helpman3,
  4. R Eitan4,
  5. Z Vaknin5,
  6. O Lavie6,
  7. A Ben Arie7,
  8. A Amit8,
  9. T Levy9,
  10. A Namazov10,
  11. I Ben Shachar11,
  12. I Atlas12,
  13. I Bruchim13,
  14. T Perri1 and
  15. O Gemer14
  1. 1hadassah medical center, Gynecologic Oncology, Jerusalem, Israel
  2. 2Hadassah, Gynecologic Oncology, Jerusalem, Israel
  3. 3Cheba medical center, Gynecologic Oncology, Ramat Gan, Israel
  4. 4Rabin Medical Center, Gynecology, Petah Tikva, Israel
  5. 5Assaf Haroffe Medical Center, Sackler School of Medicine, Gynecology, Zrifin, Israel
  6. 6Carmel Medical Center, Obstetrics and Gynecology, Haifa, Israel
  7. 72. Kaplan Medical Center, Hebrew University, Gynecology, Rehovot, Israel
  8. 8Rambam, Gymecologic Oncology, Haifa, Israel
  9. 98. Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Gynecology, Tel Aviv, Israel
  10. 10Ahmet, Gynecology, Ashkelon, Israel
  11. 11ZIv, Gynecologic Oncology, Zefat, Israel
  12. 12Poriah, Gynecologic Oncology, Tiberia, Israel
  13. 13Hillel Yafe, Gynecology, Hadera, Israel
  14. 14Barzilai Medical Center, Gynecology, Ashkelon, Israel


Objectives To compare oncological outcomes of women with high-grade endometrial carcinoma (HGEC) who underwent surgery by minimally invasive surgery (MIS) versus laparotomy.

Methods A retrospective cohort study performed in an academic multi-center setting. Consecutive women with HGEC cancer treated at 11 Israeli institutions between 2002 and 2017 were accrued in an assimilated database with a median follow-up of 52 months (range 12–120 months). Women with HGEC were stratified into two groups by route of surgery; MIS vs. laparotomy by an intention to treat. Clinical, pathological and outcome data were compared.

Results Six hundred and seventy-eight women met the inclusion criteria: 160 underwent MIS and 518 laparotomy. The two groups were comparable in demographic and clinical characteristics. Brachytherapy rate was similar in both groups (p=0.192). Disease progression and overall survival did not differ between groups (p=0.537, p=0.465, respectively). However, patients operated with MIS had almost 3 times risk to recur at their vaginal cuff or pelvis (Odds Ratio (OR) 95% Confidence Interval (CI) 2.80 (1.80–4.36)). In a multivariable analysis, including age, comorbidities, disease stage, CA-125 and lymph-vascular space invasion, MIS was associated with an increased risk for local (vaginal cuff or pelvic) recurrence (OR 95% CI 3.30 (1.69–6.48)).

Conclusions In women with HGEC, MIS was associated with higher rates of local recurrence as compared to laparotomy

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