Long-Term Surgical and Survival Outcomes of Endometrial Cancer Treated with Laparoscopic Assisted Staging Surgery

Abstract

Study ObjectiveTo assess the long-term safety and efficacy of laparoscopic assisted staging surgery in the treatment of endometrial cancer.DesignLongitudinal retrospective study.SettingTertiary center, university hospital.Patients105 patients underwent LASS due to endometrial cancer from June 1995 to June 2008.InterventionLaparoscopic assisted staging surgery for endometrial cancer.Measurements and Main ResultsShort-term and long-term surgical outcomes were analyzed. Of 105 patients, there were no case had conversion to laparotomy. Mean operation time was 186.8 minutes. Mean blood loss was 220.38 ml. Median numbers of pelvic lymph node retrieval was 18. Intraoperative complication rate was 4.8%, including 2 ureteral injury, 1 bladder injury, 1 bowel injury and 1 vascular injury. With a median follow-up for 55.3 months, six recurrence (5.7%) were recorded and the 5-year disease free survival rate and overall survival rate were 93.39 % and 98.05 % respectively. 26.7 % of patients were initially diagnosed through operative hysteroscopy and none of them had positive cytology finding of peritoneal lavage collected in final staging surgery.ConclusionOur long-term survival outcome in LASS is better than data from Taiwan Cancer Registry. Our result basing on Asian women had no obvious discrepancy from previous western population based study, which also supported the safety and efficacy of laparoscopic assisted staging surgery. Pre-LASS hysteroscopy showed neither adverse effect in survival outcome nor positive cytologic result. Study ObjectiveTo assess the long-term safety and efficacy of laparoscopic assisted staging surgery in the treatment of endometrial cancer. To assess the long-term safety and efficacy of laparoscopic assisted staging surgery in the treatment of endometrial cancer. DesignLongitudinal retrospective study. Longitudinal retrospective study. SettingTertiary center, university hospital. Tertiary center, university hospital. Patients105 patients underwent LASS due to endometrial cancer from June 1995 to June 2008. 105 patients underwent LASS due to endometrial cancer from June 1995 to June 2008. InterventionLaparoscopic assisted staging surgery for endometrial cancer. Laparoscopic assisted staging surgery for endometrial cancer. Measurements and Main ResultsShort-term and long-term surgical outcomes were analyzed. Of 105 patients, there were no case had conversion to laparotomy. Mean operation time was 186.8 minutes. Mean blood loss was 220.38 ml. Median numbers of pelvic lymph node retrieval was 18. Intraoperative complication rate was 4.8%, including 2 ureteral injury, 1 bladder injury, 1 bowel injury and 1 vascular injury. With a median follow-up for 55.3 months, six recurrence (5.7%) were recorded and the 5-year disease free survival rate and overall survival rate were 93.39 % and 98.05 % respectively. 26.7 % of patients were initially diagnosed through operative hysteroscopy and none of them had positive cytology finding of peritoneal lavage collected in final staging surgery. Short-term and long-term surgical outcomes were analyzed. Of 105 patients, there were no case had conversion to laparotomy. Mean operation time was 186.8 minutes. Mean blood loss was 220.38 ml. Median numbers of pelvic lymph node retrieval was 18. Intraoperative complication rate was 4.8%, including 2 ureteral injury, 1 bladder injury, 1 bowel injury and 1 vascular injury. With a median follow-up for 55.3 months, six recurrence (5.7%) were recorded and the 5-year disease free survival rate and overall survival rate were 93.39 % and 98.05 % respectively. 26.7 % of patients were initially diagnosed through operative hysteroscopy and none of them had positive cytology finding of peritoneal lavage collected in final staging surgery. ConclusionOur long-term survival outcome in LASS is better than data from Taiwan Cancer Registry. Our result basing on Asian women had no obvious discrepancy from previous western population based study, which also supported the safety and efficacy of laparoscopic assisted staging surgery. Pre-LASS hysteroscopy showed neither adverse effect in survival outcome nor positive cytologic result. Our long-term survival outcome in LASS is better than data from Taiwan Cancer Registry. Our result basing on Asian women had no obvious discrepancy from previous western population based study, which also supported the safety and efficacy of laparoscopic assisted staging surgery. Pre-LASS hysteroscopy showed neither adverse effect in survival outcome nor positive cytologic result.