Minimally invasive surgery versus laparotomy in women with high risk endometrial cancer: A multi-center study performed in Argentina

• Published in: Gynecologic oncology reports 2023-04, Vol.46, p.101147-101147, Article 101147
• Main Authors: Odetto, Diego, Rey Valzacchi, Guido Martin, Ostojich, Marcela, Alessandria, Sebastian, Darin, Maria Cecilia, Tapper, Karen, Rita Amato, Alicia, Luis Bianchi, Federico, Lopresti, Eduardo Fabian, Cabrera, Lorena Soledad, Costa, Jerónimo, Esteban, Agustín, Prozzillo, Luciana, Escobar, Horacio, Bustos, Daniel Gacitua, Rosato, Otilio Daniel, Picciochi, Ricardo Anibal, Garrido, Rosa María, de Degani, Graciela Lopez, Vitale, María Soledad Del Valle, Navarini, Roberto Hugo, Isnardi, Facundo, Franco, Gonzalo, Rossini, Mariano, Carrizo, María Mercedes, Perrotta, Myriam, Crimi, Gabriel
• Format: Article
• Language: English
• Subjects: Endometrial cancer; Gynecologic surgical procedures; Perioperative complications; Research Report; Surgical oncology; Surgical procedures
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2023.101147

•Disease-free survival was not different when comparing laparoscopic versus open surgery.•Overall survival at 2 years in patients with stage I–II high-risk endometrial cancer was similar.•Overall survival at 4 years in patients with stage I–II high-risk endometrial cancer was similar. Compare the perioperative outcomes and disease-free survival between minimally invasive and open surgery in women with stage I–II high-risk endometrial cancer. A retrospective, cohort study was performed involving twenty-four centers from Argentina. Patients with grade 3 endometrioid, serous, clear cell, undifferentiated carcinoma or carcinosarcoma who underwent hysterectomy, bilateral salpingo-oophorectomy, and staging between January 2010–2018 were included. Cox hazard regression analysis and Kaplan-Meier curves evaluated the association of surgical technique with survival. Of 343 eligible patients, 214 (62 %) underwent open surgery and 129 (38 %) underwent laparoscopic surgery. No significant differences were seen between the two groups with respect to greater or equal grade III Clavien-Dindo postoperative complications (11 % in the open surgery group vs 9 % minimally invasive surgery group; P = 0.34) Minimally invasive surgery was not associated with worse disease-free survival at four years (79.14 % [95 % CI 69.42– 86.08] vs 78.80 % [95 % CI 70.61–84.96]), (p = 0.25), even after creating a Cox proportional model (hazard ratio [HR] 1.08 95 % CI 0.63–1.84); (p = 0.76). There was no difference between postoperative complications nor oncologic outcomes comparing minimally invasive and open surgery among patients with high-risk endometrial cancer.