Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival Among Women With Stage I Endometrial Cancer

Abstract

clinicaltrials.gov Identifier: NCT00096408; Australian New Zealand Clinical Trials Registry: CTRN12606000261516.

Disease-Free and Survival Outcomes for Total Laparoscopic Hysterectomy Compared With Total Abdominal Hysterectomy in Early-Stage Endometrial Carcinoma: A Meta-analysis

“…Data on 3-year DFS and HRs could be extracted from 5 studies. 3,4,17,19,23 Most studies did not report details of the randomization method, but it was assumed that allocation concealment was not compromised. All analyses were on an intention to treat basis.…”

“…Table 1 shows the trials by year of commencement, and Table 2, a summary of outcomes. Four studies reported results for all survival outcomes of interest 3,17,20,23 : LR, DFS, and OS. One study reported results for DFS and LR, 4 and 1 study reported OS and LR 15 ; we were unable to obtain DFS outcomes from the authors.…”

“…One study reported results for DFS and LR, 4 and 1 study reported OS and LR 15 ; we were unable to obtain DFS outcomes from the authors. Seven studies reported all safety outcomes, 3,15,17,18,20,21,24 conversion rates of TLH to TAH, and intraoperative and postoperative complications, and 2 reported information on postoperative complications only. 16,22 All patients had International Federation of Gynecology and Obstetrics (FIGO) stages I to IV endometrial cancer.…”

“…Six studies 3,4,16,17,19,23 reported the number of LRs and are summarized as proportions in Figure 2B (Supplementary Table 4, http://links.lww.com/IGC/A608). Local recurrence was defined as recurrence in the vagina, 4 vaginal vault 3,16 or vaginal cuff 23 in 4 studies; 1 study gave no definition.…”

“…These margins were based on 2 previously published trials. 3,4 Overall survival and DFS were investigated based on the pooled HR, allowing the advantage of utilizing all the follow-up data available. Hazard ratios and variances were obtained directly from publications when available; those not reported were computed using the method of Parmar et al, 9 which accounts for censoring and differing follow-up times.…”