Laparoscopic-assisted vaginal hysterectomy versus abdominal hysterectomy in endometrial cancer
ABSTRACT To see whether laparoscopy provides exact staging and effective treatment of endometrial cancer patients, compared with total abdominal hysterectomy, with shorter hospital stay, prompter recovery, and better quality of life.
This retrospective study identified 110 patients scheduled for surgery for early-stage endometrial cancer. Fifty-five (50%) were treated by laparoscopic-assisted vaginal hysterectomy (LAVH) and 55 (50%) by total abdominal hysterectomy (TAH). All patients underwent pelvic lymphadenectomy. The majority of patients (79%) had stage I disease.
The mean number of lymph nodes removed was 17 for the LAVH group and 18.5 for the TAH group (p = 0.294). Compared with TAH, LAVH required a significantly longer operating time (220 vs. 175 min; p < 0.01); but shorter hospital stay (4 vs. 8.5 days; p < 0.001) and less estimated blood loss (177 cm3 vs. 285 cm3; p = 0.02). Overall, there were fewer post-operative complications in the LAVH group (6 vs. 11 cases; p < 0.001). Three TAH patients (5.4%) had recurrence of disease. No LAVH patients had recurrences and all are currently disease-free.
These findings suggest LAVH gives correct staging of endometrial disease, like TAH, but with fewer complications and a slightly longer operating time.
SourceAvailable from: Michele PeirettiEuropean Journal of Cancer 09/2011; 47:S67. DOI:10.1016/S0959-8049(11)70511-1 · 4.82 Impact Factor
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ABSTRACT: The objective of this study was to elucidate factors that affect prognosis in patients with stage I endometrial cancer. The study group comprised 265 patients with stage I endometrial cancer treated surgically at either of our facilities between January 1998 and December 2010 (238 patients with negative peritoneal cytology and 27 patients with positive peritoneal cytology). Progression-free survivals were evaluated between the 2 groups, and multivariate analysis was conducted with correlation factors including positive peritoneal cytology, vessel permeation, lymph node dissection, histologic diagnosis, age at diagnosis, adjuvant chemotherapy, and the depth of myometrial invasion. Disease-free survival was significantly poorer for patients with positive peritoneal cytology than those with negative peritoneal cytology on stage I disease (P = 0.000). The stratified log-rank test with vessel permeation shows the similar results. By univariate Cox model, positive peritoneal cytology, vessel permeation, and systemic lymph node dissection at surgery are significant factors on stage I endometrial cancer. Although this is a small-scale preliminary study with adjustment of other factors, positive peritoneal cytology can contribute to the risk of progression-free survival in patients with stage I endometrial cancer.International Journal of Gynecological Cancer 01/2014; DOI:10.1097/IGC.0000000000000072 · 1.95 Impact Factor
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ABSTRACT: To compare the relative merits among robotic surgery, laparoscopy, and laparotomy for patients with endometrial cancer by conducting a meta-analysis.PLoS ONE 09/2014; 9(9):e108361. DOI:10.1371/journal.pone.0108361 · 3.53 Impact Factor