Oncologic Safety of Laparoscopy in the Surgical Treatment of Type II Endometrial Cancer

Favero, Giovanni; Antón, Cristina; Xin, Le; Silva, Alexandre Silva e; Doğan, Nasuh Utku; Pfiffer, Tatiana; Köhler, Christian; Baracat, Edmund Chada; Carvalho, Jesus Paula

doi:10.1097/igc.0000000000000803

Cited by 29 publications

(25 citation statements)

References 23 publications

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“…In addition, the prevalence of laparoscopy and improvements in surgical equipment, environment, and technology may also have increased survival after hysterectomy. Although several studies found no significant improvement in overall survival among patients with EC after laparoscopy compared with laparotomy, 18,19 some reports indicated that the morbidity of hysterectomy has decreased over recent decades. 20–22 Averette et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis

et al. 2019

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Objective We aimed to compare the survival and perioperative outcomes of patients with stage II endometrial cancer (EC) undergoing simple hysterectomy (SH) or radical hysterectomy (RH), to validate the various guidelines. Methods A total of 155 consecutive patients diagnosed with stage II EC from 2000 to 2014 were reviewed. We identified 40 pairs of patients (40 SH and 40 RH) who were matched in terms of age, pathological type, and lymphovascular space invasion status using matched-pair analysis. Patient data were collected from medical records and outcomes were determined by telephone follow-up. Results Among the 80 patients in the two groups, seven died from tumor recurrence. However, cancer-related survival rates were not significantly different between the SH and RH groups. The 3-year cancer-related survival rates in the SH and RH groups were 94.97% and 92.53%, and the 5-year survival rates were 92.40% and 90.03%, respectively. Regarding perioperative outcomes, the SH group had significantly less intraoperative bleeding and a significantly shorter catheter-indwelling time than the RH group. Conclusions SH provides similar survival outcomes and a superior perioperative quality of life compared with RH in patients with stage II EC.

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Section: Discussionmentioning

confidence: 99%

Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis

et al. 2019

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“…Il est recommandé de la réaliser par technique mini-invasive si celle-ci est techniquement possible. Même si la technicité de la laparoscopie paraît plus complexe que la laparotomie avec un risque d’exérèse ganglionnaire moindre, de nombreux articles ont validé la faisabilité et de la sûreté de la laparoscopie dans les curages: il existe moins de complications post-opératoires, la durée de séjour est plus courte et les taux de survie et de récidive sont équivalents à la laparotomie [18] , [19] , [20] , [21] , [22] , [23] . De plus, le curage lombo-aortique doit s’étendre jusqu’à la veine rénale gauche car lorsque la région lombo-aortique est atteinte, il existe un taux non négligeable de métastases au-dessus de l‘artère mésentérique inférieure (77 %) [24] , [25] .…”

Section: Discussionunclassified

Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

et al. 2020

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Introduction Les carcinomes de l’endomètre de type 2 sont des cancers peu fréquents et de mauvais pronostique. Il existe très peu d’étude analysant leur prise en charge. L’objectif de l’étude était d’étudier la prise en charge des carcinomes de type 2 dans nos centres en évaluant l’application des recommandations. Matériel et méthode Il s’agit d’une étude multicentrique rétrospective enregistrant les cancers de l’endomètre de type 2 pris en charge de janvier 2009 à décembre 2019. Les analyses ont été adaptées aux dernières recommandations françaises appliquées par rapport à l’année de prise en charge. Résultats Soixante-quatorze carcinomes de type 2 ont été analysés dans dix centres: 34 carcinosarcomes (45,9 %), 29 carcinomes séreux (39,2 %), neuf carcinomes à cellules claires (12,2 %) et deux carcinomes indifférenciés (2,7 %). Lors de la prise en charge initiale, les recommandations étaient appliquées dans 45,9 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une stadification ganglionnaire chirurgicale pour 20 patientes (57,1 %). Lors de la prise en charge adjuvante, les recommandations étaient appliquées dans 37,8 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une restadification ganglionnaire chirurgicale ou radiologique pour 25 patientes (67,6 %). Discussion L’applicabilité des recommandations pour la prise en charge des carcinomes de type 2 reste difficile en raison de l’âge élevé et des comorbidités des patientes notamment pour la réalisation d’une stadification chirurgicale ganglionnaire pelvienne et lombo-aortique. L’utilisation de nouvelles techniques de stadification permettrait de mieux sélectionner les indications de curages ganglionnaires.

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“…There is a lack of data on the laparoscopic management of high-risk patients. According to our literature review, 4 recent studies have investigated laparoscopic management of patients with grade 3 and type 2 EC [14151617]. In 2012, a multicenter retrospective study, which is the first on laparoscopic management of high grade and type 2 endometrial carcinomas (n=191), concluded that high-risk histopathologic types were not a contraindication for MIS [14].…”

Section: Discussionmentioning

confidence: 99%

“…Favero et al [16] studied the feasibility, operative outcomes and oncologic safety of laparoscopic surgery in patients with type 2 EC (n=53). They concluded that LS was associated with better oncologic outcomes than LT with no statistical significance [16]. Indeed, with increasing number of patients, a statistical significance could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic surgery for low, intermediate and high-risk endometrial cancer

et al. 2019

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Objective The aim of the present study was to compare the long-term outcomes of the laparotomy (LT) and laparoscopic surgery and to evaluate the results according to low, intermediate, and high-risk groups of endometrial cancer (EC). Methods We identified 801 patients with EC and these patients were classified as group 1, who underwent LT (n=515); and group 2, who underwent laparoscopy (LS) (n=286). Patient's demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion, myometrial invasion, lymph node involvement, and risk groups, peri- and post-operative outcomes, and survival outcomes were compared between the groups according to risk classification. Survival outcomes were assessed using Kaplan-Meier method. Results The demographic characteristics of both groups were similar except age. Shorter hospital stay and fewer complications were observed in group 2. The overall survival (OS) were similar in the low, low-intermediate, high-intermediate and high-risk groups (p=0.269, 0.476, 0.078, and 0.085; respectively) for LS compared to LT. The covariate analysis revealed that the death and recurrence risks were approximately twice higher in the LT group than in the LS group (odds ratio [OR]=1.9; 95% confidence interval [CI]=1.2–3.1 for OS; OR=2.0; 95% CI=1.2–3.3 for disease-free survival). Conclusion The results of our study support the well-known positive aspects of LS as well as safe and effective use in cases of intermediate and high-risk EC.

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Oncologic Safety of Laparoscopy in the Surgical Treatment of Type II Endometrial Cancer

Cited by 29 publications

References 23 publications

Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis

Comparison of survival and perioperative outcomes following simple and radical hysterectomy for stage II endometrial cancer: a single-institution, retrospective, matched-pair analysis

Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

Laparoscopic surgery for low, intermediate and high-risk endometrial cancer

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