Abstract
Objective: The aim of this study was to compare laparoscopic (LPS) and laparotomy (LPT) approaches for endometrial cancer, and to assess intraoperative and postoperative results, disease-free survival and overall survival. Methods: We designed a prospective observational study, every patient diagnosed of endometrial cancer and subsidiary to surgical staging was included. Total hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy were performed in every case. Paraaortic lymphadenectomy was performed depending on tumor histology. Results: 70 patients with endometrial cancer were enrolled, 49 (70%) were treated laparoscopically and 21 (30%) laparotomically. There was not statistical significant difference in the mean operative time, it was 183.06 ± 21.03 min (range 120 - 230) in the LPS group and 195.24 ± 28.39 min (range 130 - 240) in the LPT group, mean difference 12.16 (95% CI ﹣0.2 - 24). There was no difference in the number of lymph nodes resected. Mean blood loss was lower in the LPS group. There were less postoperative complications, 3 (6.12%) in the LPS group and 7 (33.3%) in the LPT group (p Conclusion: Laparoscopic approach for endometrial cancer offers similar results in terms of survival and oncological radicality as the laparotomic approach and a lower rate of complications, a quicker convalescence time and a shorter hospital stay.
Highlights
Endometrial cancer is the most common gynecologic malignancy in the developed countries
We designed a prospective observational study, every patient diagnosed of endometrial cancer and subsidiary to surgical staging was included
Bilateral adnexectomy, pelvic lymphadenectomy were performed in every case
Summary
Endometrial cancer is the most common gynecologic malignancy in the developed countries. There are approximately 47,100 new cases and 8000 deaths from the disease in the USA [1]. Incidence rates of endometrial cancer have been raising due to increasing life expectancy as this disease frequently appears in women older than 55 years. Some risk factors that increase the estrogen level are: obesity, early menarche, late menopause, nulliparity and tamoxifen use. Women with Lynch syndrome are at an elevated risk of endometrial cancer, along with other malignancies [2]. Most cases are diagnosed while in stage I, limited to the uterus. Fiveyear survival rate after surgery is very high, 88% [3]
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