PT  - JOURNAL ARTICLE
AU  - Perri, T
AU  - Kogan, L
AU  - Helpman, L
AU  - Eitan, R
AU  - Vaknin, Z
AU  - Lavie, O
AU  - Ben Arie, A
AU  - Amit, A
AU  - Levy, T
AU  - Namazov, A
AU  - Ben Shachar, I
AU  - Atlas, I
AU  - Bruchim, I
AU  - Levin, G
AU  - Gemer, O
TI  - EPV133/#555 Minimally invasive approach in endometrial cancer with lower uterine segment involvement in ≥ stage ii: is it safe?
AID  - 10.1136/ijgc-2021-IGCS.203
DP  - 2021 Nov 01
TA  - International Journal of Gynecologic Cancer
PG  - A83--A83
VI  - 31
IP  - Suppl 4
4099  - http://ijgc.bmj.com/content/31/Suppl_4/A83.1.short
4100  - http://ijgc.bmj.com/content/31/Suppl_4/A83.1.full
SO  - Int J Gynecol Cancer2021 Nov 01; 31
AB  - Objectives To compare survival outcomes between women with stages II-IV endometrial carcinoma (EC) with lower uterine segment involvement (LUSI), staged by minimally invasive surgery (MIS) and those staged by laparotomy.Methods A retrospective multi-center cohort study of nine gynecologic-oncology centers. Univariate analysis, Kaplan-Meier survival and Cox proportional hazard models analysis were performed to compare women surgically staged by MIS and those operated by laparotomy in different stages and histology of EC.Results Over a median follow-up period of 3 years (interquartile range, 1.5–6 years) 212 women were included, 68 (32.1%) were surgically staged by MIS. Stages of disease among the study cohort were stages II, III and IV, 32.1%, 51.9%, and 16.0%, respectively. Stage distribution did not vary between MIS and laparotomy groups (p=0.144). High-grade histology was less common in MIS group (44.1% vs. 67.4%, p<0.001). Adjuvant radiation and chemotherapy rates were comparable. Recurrence (local and distal) rate did not differ between groups (44.1% MIS vs. 31.9% laparotomy, p=0.084). Local recurrence rate was higher in MIS group (32.4% vs. 18.1%, p=0.023). Overall survival and local recurrence-free survival were similar in both groups (log rank test p=0.08, p=0.33, respectively). In Cox regression model adjusting for age, comorbidities, tumor grade, disease stage and adjuvant therapy, route of surgery (MIS vs. laparotomy) was not associated with overall survival (p=0.169) or local recurrence (p=0.296).Conclusions In women with stage II-IV EC with LUSI, MIS was associated with higher local recurrence rate, yet overall survival was comparable between patients with MIS and laparotomy, regardless of adjuvant therapy.