Introduction/Background Although minimal invasive approach has been established as the standard surgical treatment in early stage endometrial cancer, the oncological safety of laparoscopy when cervix is involved is not based on strong evidence. Our retrospective analysis aims to investigate whether there is any difference on overall and cancer specific survival between patients treated by laparoscopy and laparotomy for stage II endometrial cancer in a single Cancer Centre over a decade.
Methodology Our cohort consisted of all patients operated in Oxford University Hospitals Trust between 2010 and 2020 with microscopically proven stage II endometrial cancer. The audit was registered according to the local equirements with registration number 5832. Categorical variables were compared using chi-square test and continuous variables with independent samples t-test. Survival rates were determined from Kaplan-Meier Curves and compared using log-rank test. Statistical significance was considered for p<0.05.
Results Of the 47 patient of our cohort 33 (70%) underwent laparoscopy, whereas 14 patients were treated with laparotomy (30%). There was no difference in mean age (p=0.86), mean BMI (p=0.76) and comorbidity index (p=0.96) between the two groups. Histopathological features were also similar in terms of histological type (p=0.32), LVSI (p=0.15) and depth of myometrial invasion (p=0.07). Patients in both groups recieved similar adjuvant treatment (p=0.11). There was no difference on overall (p=0.606) and cancer specific survival (p=0.564) between the two groups. The estimated overall 5-year survival was 65.5% for the laparoscopy and 50% for the laparotomy group and the disease specific 5-year survival 79.3% and 67.7% respectively.
Conclusion In our study we did not find any difference in overall and cancer specific survival between the two approaches. To clearly identify any potential adverse outcomes in relapse or survival terms regarding minimal invasive compared to open surgery in stage II endometrial cancer a prospective randomized trial is required.
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