Laparoscopic treatment of endometrial cancer: five-year recurrence and survival rates

Purpose: To evaluate the 5-year recurrence and survival of patients with clinical Stage I endometrial cancer treated by the laparoscopic approach.

Methods: Retrospective review of 56 patients with clinical Stage I endometrial cancer treated laparoscopically. The mean follow-up was 6.4 (4.8-9.6) years. The International Federation of Obstetricians and Gynecologists (FIGO) surgical staging was: I, 45 (80.4%); II, three (5.4%); III, six (10.7%); and IV, two (3.6%).

Results: For patients with surgical Stage I (n = 45), the 5-year recurrence rate was 4.9% and the 5-year cause-specific survival was 94.7%. Factors univariately associated with survival were grade (p = .017), depth of myometrial invasion (p = .018), node metastasis (p = .013), and surgical stage according to FIGO (p = .097).

Conclusion: The laparoscopic approach provided 5-year survival and recurrence rates similar to those previously attained by laparotomy in our institution.

Endometrial cancer; Hysterectomy; Laparoscopic lymphadenectomy

[1] Magrina J.F., Serrano L., Cornella J.L.: "Laparoscopic lymphadenectomy and radical or modified radical vaginal hysterectomy for endometrial and cervical carcinoma: preliminary experience". J. Gynecol. Surg., 1995, 11, 147.

[2] Magrina J.F., Mutone N.F., Weaver A.L., Magtibay P.M.: "Fowler RS, Cornella JL. Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer: morbidity and survival". Am. J. Obstet. Gynecol., 1999, 181, 376.

[3] FIGO Cancer Committee: "Staging announcement". Int. J. Gynecol. Obstet., 1989, 28, 190.

[4] Boike G., Lurain J., Burke J.: "A comparison of laparoscopic management of endometrial cancer with traditional laparotomy" (abstract). Gynecol. Oneal., 1994, 52, 105.

[5] Spirtos N.M., Schlaerth J.B., Gross G.M., Spirtos T.W., Schlaerth A.C., Ballon S.C.: "Cost and quality-of-life analyses of surgery for early endometrial cancer: laparotomy versus laparoscopy". Am. J Obstet. Gynecol., 1996, 174, 1795.

[6] Manolitsas T.P., McCartney A.J.: "Total laparoscopic hysterectomy in the management of endometrial carcinoma". J. Am. Assoc. Gynecol. Laparosc., 2002, 9, 54.

[7] 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". Gyneco/. Oncol., 1999, 73, 5.

[8] Holub Z., Jabor A., Bartos P., Eim J., Urbanek S., Pivovarnikova R.: "Laparoscopic surgery for endometrial cancer: long-term results of a multicentric study". Eur. J. Gynaecol. Onco/., 2002, 23, 305.

[9] Malur S., Passover M., Michels W., Schneider A.: "Laparoscopicassisted vaginal versus abdominal surgery in patients with endometrial cancer - a prospective randomized trial". Gynecol. Oncol., 2001, 80, 239.

[10] Langebrekke A., Istre 0., Hallqvist A.C., Hartgill T.W., Onsrud M.: "Comparison of laparoscopy and laparotomy in patients with endometrial cancer". J. Am. Assoc. Gynecol. Laparosc., 2002, 9, 152.

[11] Holub Z., Voracek J., Shomani A.: "A comparison of laparoscopic surgery with open procedure in endometrial cancer". Eur. J. Gynaecol. Oncol., 1998, 19, 294.

[12] Malkasian G.D. Jr., Annegers J.F., Fountain K.S.: "Carcinoma of the endometrium: Stage I". Am. J. Obstet. Gynecol., 1980, 136, 872.

[13] Eltabbakh G.H.: "Analysis of survival after laparoscopy in women with endometrial carcinoma". Cancer, 2002, 95, 1894.

[14] Malkasian G.D. Jr.: "Carcinoma of the endometrium: effect of stage and grade on survival". Cancer, 1978, 41, 996.