Endometrial cancer recurrence after laparoscopic surgery: A report of two cases

Abstract

Laparoscopic surgery is a minimally invasive approach and is therefore widely popular among gynecologists for both benign and malignant disease. Laparoscopic surgery for early endometrial cancer was covered by the National Health Insurance System in Japan in 2014, and is routinely performed nationwide since 2014.Several overseas studies have reported that the prognosis of laparoscopic surgery for endometrial cancer is similar to that observed with open surgery; however, few studies have discussed this subject in Japan.Our facility introduced this surgery in 2014, and 50 surgeries were performed between April 2014 and December 2020. During the follow-up period, we observed recurrence, para-aortic lymph node metastasis, omental metastasis, and vaginal implantation metastasis in two patients. We report two cases of recurrence based on the previous literature. In this study, we investigated the clinical aspects of laparoscopic surgery for endometrial cancer at our hospital. Based on our observations in these two cases, we emphasize the importance of optimal patient selection and evaluation of laparoscopy for the surgical management of endometrial cancer. To achieve oncologic outcomes comparable with those of laparotomy, it is important to develop safe laparoscopic procedures to prevent cancer recurrence. The accumulation of more cases is warranted to refine the laparoscopic procedure.