Minimally invasive surgery versus open surgery for uterine sarcomas - a retrospective study

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Cancer Research

Background:

• Uterine sarcomas are rare, aggressive gynecologic malignancies.
• Surgical management is the cornerstone of treatment.
• Minimally invasive surgery (MIS) offers potential benefits but oncologic outcomes compared to open surgery require evaluation.

Purpose of the Study:

• To compare the oncologic outcomes, specifically progression-free survival (PFS) and overall survival (OS), between minimally invasive surgery (MIS) and open surgery for uterine sarcomas.
• To evaluate the safety and efficacy of MIS in treating uterine sarcomas.

Main Methods:

• Retrospective analysis of 37 patients with high-grade endometrial stromal sarcoma and leiomyosarcoma undergoing surgery between 2003 and 2024.
• Patients were stratified into two groups: MIS and open surgery.
• Co-primary endpoints were PFS and OS, analyzed using log-rank tests and Cox regression.

Main Results:

• No significant difference in PFS (p=0.378) or OS (p=0.625) was observed between MIS and open surgery groups.
• Adjusted Cox regression analysis indicated MIS was not associated with differences in PFS (HR 0.44) or OS (HR 0.75).
• Baseline characteristics and disease stages were similar across both surgical approach groups.

Conclusions:

• Minimally invasive surgery (MIS) appears to provide comparable oncologic outcomes to open surgery for uterine sarcomas.
• Further investigation with larger patient cohorts is warranted to validate these findings and solidify MIS as a viable surgical option.