Is total laparoscopic surgery for endometrial carcinoma at risk of local recurrence? A long-term survival.
BACKGROUND
Loco-regional recurrences after laparotomic surgery for early endometrial carcinoma have an incidence of 3-8%. This study examined the pattern of recurrences and survival after full laparoscopic hysterectomy.


METHODS
Between January 1997 and December 2002, 113 consecutive patients with pre-operative Stage I endometrial cancer, self-referred to two different surgical teams, were treated by the laparoscopic approach by one team and by the laparotomic approach by the other team.


RESULTS
Nineteen patients were treated by total laparoscopic hysterectomy (TLH) by the endoscopic group, and 94 were treated by total abdominal hysterectomy (TAH) by the oncologic group. Sixteen patients (84.2%) in the laparoscopic group and 79 patients (84.0%) in the laparotomic group had Stage I disease. The mean age and mean weight did not differ in the two groups. With a mean follow-up of 52.2 months for the TLH group and 43.6 months for the TAH group, one recurrence (5.3%) was observed in the former group and 9 recurrences (10.6%) in the latter group. No significative differences were observed for disease-free survival and overall survival.


CONCLUSIONS
Total laparoscopic hysterectomy does not increase the risk of local recurrence and does not affect survival for patients with early stage endometrial carcinoma.
Seracchioli
Renato
R
Service of Reproductive Surgery, University of Bologna, Italy.
Venturoli
Stefano
S
Ceccarin
Michela
M
Cantarelli
Marianna
M
Ceccaroni
Marcello
M
Pignotti
Elettra
E
De Aloysio
Domenico
D
De Iaco
Pierandrea
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome