Comparison of the Oncologic Outcomes between Exploratory Laparotomy and Laparoscopic Surgery for Endometrial Cancer: Siriraj Experience

Abstract

Objective: This study was undertaken to evaluate surgical and oncologic outcomes for patients with endometrial cancer, compared between exploratory laparotomy and laparoscopic surgery.Methods: In total, 324 patients who diagnosed with endometrial cancer during January 2007 to December 2016 were enrolled. The comprehensive surgical staging procedures, including total hysterectomy, bilateral salpingo-oophorectomy (BSO), pelvic lymphadenectomy (PL), and/or para-aortic lymphadenectomy (PAL) were undergone. Demographic, clinical, treatment, operative, outcome, and survival outcome were recorded and evaluated. Results: 81 patients performed laparoscopy without conversion. No significant difference in baseline characteristics and pathological characteristics between two groups was observed. When compared with laparotomy group, the laparoscopy group had longer operative time, shorter hospital stays, and lower blood loss. Two-year overall survival (OS) was 97.9% and 95.1% in the laparotomy and laparoscopy groups, respectively (p=0.263). In addition, 2-year disease-free survival (DFS) between both groups was equal (93.7% versus 88.6%, respectively; p=0.309). Conclusion: Laparoscopic surgery is an efficacious, achievable and safe technique for patients with endometrial cancer. Good surgical skills and proper surgical techniques are required to effectuate optimal outcomes.