Introduction/Background Endometrial carcinoma is the most frequent gynaecological malignancy in the Western world, with around 100.000 cases in Europe each year. In recent years, a new molecular classification has divided endometrial carcinomas into four distinct subgroups with specific molecular characteristics. A fourth subgroup is a group of carcinomas with an aggressive growth pattern and poor outcomes. The most typical representative is serous endometrial carcinoma; others include clear cell carcinoma, uterine carcinosarcoma and high-grade endometrioid carcinoma.

Methodology A retrospective, observational study of a single tertiary-level centre between January 2013 and December 2015. Clinical data were gathered from the Division of Gynaecology and Obstetrics archive, University Medical Centre Ljubljana.

Results A total of 366 patients were surgically treated with histologically verified endometrial carcinoma. Out of those, 66 were treated for high-risk endometrial cancer.; 27 with serous carcinoma, 22 with high-grade endometrioid carcinoma, 12 had carcinosarcomas, 3 had clear cell carcinomas, and two had dedifferentiated carcinomas. The surgical approach was divided between minimally invasive and open surgery; 35 cases were completed laparoscopically, 31 with open surgery, which included two conversions. There were ten cancer-related deaths in the laparoscopic arm and 17 in the open arm. There were no statistically significant differences between both arms. However, more advanced-stage disease (II-IVB) cases were in the open arm, 18 vs 15.

Conclusion ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma recommend minimally invasive procedures in FIGO stages I and II. However, with a more extensive lymphadenectomy required in the high-risk group, an open technique still has its place. The surgical approach in stage III and IV disease must be decided with a goal of complete cytoreduction.

Disclosures No