Does the Type of Surgical Approach and the Use of Uterine Manipulators Influence the Disease-Free Survival and Recurrence Rates in Early-Stage Endometrial Cancer?
Por:
Marcos J, Lopez J, Sanchez J, Piñero-Sánchez ÓC, Román M, Quijada M, Candela A and Martinez J
Publicada:
1 nov 2016
Resumen:
Objective: The purpose of this study was to compare the long-term
safety, disease-free survival, and recurrence rate of total laparoscopic
hysterectomy using uterine manipulator and abdominal hysterectomy in the
surgical treatment in early-stage endometrial cancer.
Study Design: This was a cohort study of 147 patients with clinical
endometrial cancer (laparoscopic surgery group, 77 women; laparotomy
group, 70 women). Data were evaluated and analyzed by intention-to-treat
principle, and survival data of stage I endometrial cancer (129
patients; 66 from laparoscopic surgery group and 60 from laparotomy
group) were estimated by using the Kaplan-Meier curves.
Results: After a follow-up period of 60 months for both laparoscopic
surgery and laparotomy groups, no significant difference in the
cumulative recurrence rates (7.4% and 13.1%, P 0.091) and overall
survival (97.1% and 95.1%, P 0.592) was detected between both groups of
stage I endometrial cancer. Conversion to laparotomy occurred in 10.4%
(8/ 77) of the laparoscopic procedures. Laparoscopic hysterectomy was
associated with less use of pain medication (P = 0.001) and a shorter
hospital stay (P < 0.001), but the procedure took longer than
laparotomic hysterectomy (P < 0.001). The proportion of patients with
intraoperative and long-term complications was not significantly
different between both groups. The use of uterine manipulators did not
have increased recurrence rate in patients treated with laparoscopic
approach.
Conclusions: The laparoscopic surgery approach to early-stage
endometrial cancer using uterine manipulators is as safe and effective
as the laparotomic approach.
Filiaciones:
Marcos J:
Departments of *Obstetrics and Gynecology and †Public Health, Hospital General Universitari D'Alacant, Alicante, Spain
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