Comparison of the Oncologic Outcomes between Exploratory Laparotomy and Laparoscopic Surgery for Endometrial Cancer: Siriraj Experience

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Pisutt Srichaikul
http://orcid.org/0000-0002-6541-7304
Jidapa Samrarn
http://orcid.org/0000-0003-0710-8105
Atthapon Jaishuen
http://orcid.org/0000-0001-7618-4609
Hideaki Yahata
http://orcid.org/0000-0003-3142-8993
Peerapong Inthasorn
http://orcid.org/0000-0002-6617-0307
Korakot Sirimai
http://orcid.org/0000-0002-7475-7757
Pavit Sutchritpongsa
http://orcid.org/0000-0002-1974-0434
Amphan Chalermchockcharoenkit
http://orcid.org/0000-0001-5776-6988
Prasong Tanmahasamut
http://orcid.org/0000-0002-5152-1725

Abstract

Objective: This study was undertaken to evaluate surgical and oncologic outcomes for patients with endometrial cancer, compared between exploratory laparotomy and laparoscopic surgery.
Methods:
In total, 324 patients who diagnosed with endometrial cancer during January 2007 to December 2016 were enrolled. The comprehensive surgical staging procedures, including total hysterectomy, bilateral salpingo-oophorectomy (BSO), pelvic lymphadenectomy (PL), and/or para-aortic lymphadenectomy (PAL) were undergone. Demographic, clinical, treatment, operative, outcome, and survival outcome were recorded and evaluated.
Results:
81 patients performed laparoscopy without conversion. No significant difference in baseline characteristics and pathological characteristics between two groups was observed. When compared with laparotomy group, the laparoscopy group had longer operative time, shorter hospital stays, and lower blood loss. Two-year overall survival (OS) was 97.9% and 95.1% in the laparotomy and laparoscopy groups, respectively (p=0.263). In addition, 2-year disease-free survival (DFS) between both groups was equal (93.7% versus 88.6%, respectively; p=0.309).
Conclusion: Laparoscopic surgery is an efficacious, achievable and safe technique for patients with endometrial cancer. Good surgical skills and proper surgical techniques are required to effectuate optimal outcomes.

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How to Cite
Srichaikul, P. ., Samrarn, J. ., Jaishuen, A. ., Yahata, H. ., Inthasorn, P. ., Sirimai, K. ., Sutchritpongsa, P. ., Chalermchockcharoenkit, A. ., & Tanmahasamut, P. . (2020). Comparison of the Oncologic Outcomes between Exploratory Laparotomy and Laparoscopic Surgery for Endometrial Cancer: Siriraj Experience. Siriraj Medical Journal, 72(3), 195–201. https://doi.org/10.33192/Smj.2020.26
Section
Original Article

References

1. Spirtos NM, Schlaerth JB, Gross GM, Spirtos TW, Schlaerth AC, Ballon SC. Cost and quality of life analyses of surgery for early endometrial cancer: laparotomy versus laparoscopy. Am J Obstet Gynecol 1996;174:1795-800.
2. Magrina JF, Mutone NF, Weaver AL, Magtibay PM, Fowler RS, Cornella JL. Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer: morbid and survival. AM J Obstet Gynecol 1999;181:376-81.
3. Gemignani ML, Curtin JP, Zelmanovich J, Patel DA, Venkatrama E, Barakat RR. Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges. Gynecol Oncol 1999;73:5-11.
4. Tozzi R, Malur S, Koehler C, Schneider A. Laparoscopy versus laparotomy in endometrial cancer: First analysis of survival of a randomized prospective study. J Minim Invasive Gynecol 2005;12:130-6.
5. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol 2009;27:5331-6.
6. Palomba S, Falbo A, Mocciaro R, Russo T, Zullo F. Laparoscopic treatment forendometrial cancer: A meta-analysis of randomized controlled trials (RCTs). Gynecol Oncol 2009;112:415-21.
7. Zullo F, Palomba S, Falbo A, Russo T, Mocciaro R, Tartaglia E, et al. Laparoscopic surgery vs laparotomy for early stage endometrial cancer: long-term data of a randomized controlled trial. Am J Obstet Gynecol 2009;200:296.e1-9.
8. Terao Y, Kitade M, Kusunoki S, Fujino K, Ujihira T, Kimura M, et al. Surgical and oncological outcome of laparoscopic surgery, compared to laparotomy, for Japanese patients with endometrial cancer. Gynecol Minim Invasive Ther 2016;5:64-8.
9. Kong TW, Lee KM, Cheong JY, Kim WY, Chang SJ, Yoo SC, et al. Comparison of laparoscopic versus conventional open surgical staging procedure for endometrial cancer. J Gynecol Oncol 2010;2:106-11.
10. Srichaikul P, Chalermchockcharoenkit A, Yahata H, Sirimai K, Sutchritpongsa P. Low complication rate associated with total laparoscopic hysterectomies using the retroperitoneal approach: A Series of 1,092 Cases in Siriraj Hospital. Siriraj Med J 2018;70:191-7.
11. Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, et al. Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study. J Clin Oncol 2012;30:695-700.
12. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N. Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet 2010;375:1165-72.
13. Malzoni M, Tinelli R, Cosentino F, Perone C, Rasile M, Luzzolino D, et al. Total laparoscopic hysterectomy versus abdominal hysterectomy with lymphadenectomy for early-stage endometrial cancer: a prospective randomized study. Gynecol Oncol 2009;112:126-33.

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