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Laparoscopic management of early stage endometrial cancer
1Department of Gynaecology & Obstetrics, University of Padova, Italy
*Corresponding Author(s): P. Litta E-mail:
Purpose of investigation: The purpose of this study was to evaluate the feasibility of laparoscopic hysterectomy versus the transabdominal approach with systemic pelvic lymphadenectomy in early stage endometrial cancer.
Methods: From January 1996 to April 2002, 59 women were treated for endometrial cancer at the Department of Gynecology in Padova, Italy (29 by the laparoscopic technique and 30 by laparotomy). Every patient underwent hysterosalpingo-oophorectomy with systemic pelvic lymphadenectomy.
Results: Comparing the two techniques, operating time was longer and hospital stay was significantly shorter for laparoscopy; no differences were observed about the number of removed lymph nodes (range 5-33) or intra-postoperatory complications.
Conclusion: The laparoscopic approach to endometrial cancer is certainly to be considered appropriate and efficacious, even if it requires skilled surgeons and adequate oncologic training. It is important to perform pelvic lymphadenectomy in all cases of early stage cancer.
Endometrial cancer; Laparoscopic hysterectomy; Laparotomic hysterectomy; Lymphadenectomy
P. Litta,M. Fracas,C. Pozzan,F. Merlin,C. Saccardi,G. Sacco,D. Mannici. Laparoscopic management of early stage endometrial cancer. European Journal of Gynaecological Oncology. 2003. 24(1);41-44.
[1] Greenlee R.T., Murray T., Bolden S., Wingo P.A.: "Cancer statisties 2000". Cancer J. Clin., 2000, 50, 7.
[2] Kurman R. J.: Blaunstain's Pathology of Genital Tract, 1994, 4th ed.
[3] Barakat R. R., Park R. C., Grigsby P. W., Muss H. D., Norris H. J.: "Corpus: epithelial tumors". In: Hoskins W. J., Perez C. A., Young R. C. (eds.): "Principles and Practice of Gynaecologic Oncology". 2"d ed. Philadelphia, P.A.: Lippincott, 1997, 859.
[4] Massi G., Savino L., Susini T.: "Vaginal hysterectomy versus abdominal hysterectomy for the treatment of Stage I endometrial adenocarcinoma". Am. J. Obstet. Gynecol., 1996, 174 (4), 1320.
[5] Onnis A., Marchetti M.: "Adequate staging for an adequate management in uterine cancers. Clinical experience", Eur. J. Gyn Oneal., 1991, 12, 2.
[6] Gemignani M. L., Curtin J. P., Zelmanovich J., Patel D. A., Venkatraman E., Barakat R. R.: "Laparoscopic-assisted vaginal hysterectomy for endometrial cancer: clinical outcomes and hospital charges". Gynecol. Oneal., 1999, 73, 5.
[7] Spirtos N. M., Schlaerth J. B., Gross G. M., Spirtos T. W., Schlaerth A. C., Ballooon S. C.: "Cost and quality-of.life analyses of surgery for early endometrial cancer: laparotomy versus laparoscopy". Am. J. Obstet. Gynecol., 1996, 174 (6), 179.
[8] Bokhman J. V.: "Annual report on the results of treatment in gynecological cancer". J. Epid. Biostat., 2001, 6, 45.
[9] Childers J.M., Brzechffa P.R., Hatch K. D., Surwit E. A.: "Laparoscopically assisted surgical staging (LASS) of endometrial cancer". Gynecol. Oneal., 1993, 51, 33.
[10] Manolitsas T. P., McCartney A. J.: "Total laparoscopic hysterectomy in the management of endometrial carcinoma". J. Am. Assoc. Gynecol. Laparosc., 2002, 9 (1), 54.
[11] D. Creasman W. T., Morrow C. P., Bundy B. N., Homesley H. D., Graham J. E., Heller P. B.: "Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study". Cancer, 1987, 60, 2035.
[12] "Cancer Committee staging announcement". FIGG Int. J. Gynaecol. Obstet., 1989, 28, 190.
[13] F. Bremond A., Bataillard A., Thomas L., Achard J. L., Fevers B., Fondrinier E. et al.: "Federation Nationale des Centres de Lutte Contre le Cancer. Standards, opinions and recommendations for the surgical management of carcinoma of endometrium". Bull. Cancer, 2001, 88 (2), 181.
[14] G. Descamps P., Body G., Calais G., Moire C., Fignon A., Jourdain O. et al.: "Stage I and II endometrial cancer: should lynphadenectomy still be done?". J. Gynecol. Obstet. Biol. Reprod (Paris), 1995, 24 (8), 794.
[15] H. Gao Y., Yu A., Chen L.: "Place of value of pelvic lymphadenectomy for treatment of endometrial neoplasms". Zhonghua Fu Chan Ke Za Zhi, 2000, 35 (5), 264.
[16] I. Parker S. L., Tong T., Bolden S., Wingo P. A.: "Cancer statistics 1996". Cancer J. Clin., 1996, 46, 5.
[17] L. Benedetti P. P., Cutillo G., Croce C., Maneschi F., Angioli R.: "II significato della linfoadenectomia nel carcinoma dell'endometrio. Aggiornamento permanente in Ostetricia e Ginecologia, 2001, 5 (2), 49. Review ed. Pacini.
[18] Bloss J. D., Barman M. L., Bloss L. P., Buller R. E.: "Use of vaginal hysterectomy for the management of Stage I endometrial camper in the medically compromised patients". Gynecol. Oneal., 1991, 40, 74.
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