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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
Published on: August 19, 2021
Laparoscopy versus laparotomy in endometrial cancer: first analysis of survival of a randomized prospective study
Roberto Tozzi1, Sabine Malur, Christhardt Koehler
1Department of Gynaecologic Oncology, The Royal Marsden Hospital, London, United Kingdom.
Study Objective:
Laparoscopy has been proved to be safe and reliable in staging of patients with endometrial cancer. It has definite advantages over laparotomy, but a comparable survival outcome is still to be verified in prospective randomized trials.
Design:
Prospective, randomized clinical trial.
Setting:
Department of Gynecology, Friedrich Schiller University, Jena, Germany.
Patients:
One hundred twenty-two women with uterine cancer.
Interventions:
Laparotomy and laparoscopy.
Measurements And Main Results:
Sixty-three patients were allocated to the laparoscopy arm, and 59 were allocated to the laparotomy arm. Median follow-up for all patients was 44 months (range 5-96 months). Eight patients (12.6%) in the laparoscopy group had a recurrence versus five patients (8.5%) in the laparotomy group (p = .65). At median follow-up, disease-free survival (DFS) and overall survival (OS) in the laparoscopy group and laparotomy group were 87.4% versus 91.6% and 82.7% versus 86.5%, respectively. Cause-specific survival (CSS) was 90.5% in the laparoscopy group versus 94.9% in the laparotomy group. In patients with International Federation of Gynecology and Obstetrics stage I, DFS was 91.2% in the laparoscopy group versus 93.8% in the laparotomy group, OS was 86.5% versus 89.7%, and CSS was 93.4% versus 95.9%.
Conclusion:
Laparoscopic vaginal treatment of patients with endometrial cancer provides a survival outcome comparable with laparotomy. If these data are confirmed, laparoscopic procedures should be included in routine therapy for patients with endometrial cancer.
