Role of minimally invasive surgery versus open approach in patients with early-stage uterine carcinosarcomas: a retrospective multicentric study

Abstract

Objective The aim of this retrospective study was to compare surgical and survival outcome in only patients with early-stage UCSs managed by laparotomic surgery (LPT) versus minimally invasive surgery (MIS). Methods Data were retrospectively collected in four Italian different institutions. Inclusion criteria were UCS diagnosis confirmed by the definitive histological examination, and stage I or II according to the FIGO staging system. Results Between August 2000 and March 2019, the data relative to 170 patients bearing UCSs were collected: of these, 95 were defined as early-stage disease (stage I–II) based on the histological report at the primary surgery, and thus were included in this study. Forty-four patients were managed by LPT, and 51 patients were managed by MIS. The operative time was lower in the MIS group versus the LPT group (p value 0.021); the median estimated blood loss was less in the MIS group compared to the median of LPT group (p value < 0.0001). The length of hospital stay days was shorter in the MIS patients (p value < 0.0001). Overall, there were eight (8.4%) post-operative complications; of these, seven were recorded in the LPT group versus one in the MIS group (p value 0.023). There was no difference in the disease-free survival (DFS) and overall survival (OS) between the two groups. Conclusion There was no difference of oncologic outcome between the two approaches, in face of a more favourable peri-operative and post-operative profile in the MIS group.

Survival after laparoscopy versus laparotomy for apparent early-stage uterine clear cell carcinoma: Results of a large multicenter cohort study

“…Furthermore, the subgroup analysis showed that the employment of a uterine manipulator during laparoscopy surgery did not worsen the DFS (HR=1.01, 95% CI=0.65-1.58, P=0.960), the OS (HR=1.18, 95% CI=0.71-1.96, P=0.530), and the recurrence rate (HR=1.12, 95% CI=0.67-1.87, P=0.660) among patients with high-risk EC (25). To compare surgical and survival outcomes in patients with early-stage uterine carcinosarcoma managed by laparotomic surgery versus minimally invasive surgery, the study conducted by Corrado et al included 170 patients and concluded that for women with early-stage uterine carcinosarcoma, there was no difference of oncologic outcome between the two approaches (26). The findings of our study were consistent with that of the aforementioned studies.…”

“…To compare surgical and survival outcomes in patients with early-stage uterine carcinosarcoma managed by laparotomic surgery versus minimally invasive surgery, the study conducted by Corrado et al. included 170 patients and concluded that for women with early-stage uterine carcinosarcoma, there was no difference of oncologic outcome between the two approaches ( 26 ). The findings of our study were consistent with that of the aforementioned studies.…”

Sentinel Lymph Node in Aged Endometrial Cancer Patients “The SAGE Study”: A Multicenter Experience

“…FIGO (International Federation of Gynecology and Obstetrics) staging guidelines require the execution of total hysterectomy, bilateral salpingo-oophorectomy, and nodal assessment ( 9 ) with the minimally invasive approach progressively acquiring a pivotal role in this management ( 10 – 13 ), especially in older patients ( 14 ).…”

Clinical Analysis of the Discovery of Malignant Gynecological Tumors in the Diagnosis and Treatment of Pelvic Organ Prolapse

“…In addition, patients with gynecological tumor surgery for abdominal or laparoscopic approach, commonly less choice by vaginal surgery, the tumor operation at the same time, choose the self organization pelvic reconstructive surgery in patients with no obvious prolong operation time, increase the complications of the case not only correct the patients with pelvic organ prolapse, and improve the patients quality of life, also can be the greatest degree to reduce the effects of cancer treatment ( 10 ). Comprehensive stage malignant tumor by laparoscopic surgery can obviously reduce the operation time, intraoperative hemorrhage, and length of hospital stay, reduce patient pain, prolapse patients laparoscopic autologous fascia revascularization anatomy and surgical field more clearly, hemostatic more thoroughly, a collection of 170 patients with uterine sarcoma of the data comparing laparoscopic surgery and laparotomy, Laparoscopic surgery was found to have more favorable perioperative and postoperative outcomes, with no difference in disease-free survival (DFS) and overall survival (OS) between the two groups ( 11 ).…”