title: Analysis of survival after laparoscopic management of endometrial cancer.
abstract: OBJECTIVE
  To assess the effect of laparoscopic surgery on the survival of women with early-stage endometrial cancer and to analyze the factors that affect survival.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Tertiary teaching hospital.
  
  
  METHODS
  Women with clinical stage I and II endometrial cancer (International Federation of Gynecology and Obstetrics staging, 1971) from January 1993 through June 2003.
  
  
  METHODS
  Demographic, surgical, perioperative, and pathologic characteristics of women treated with laparoscopy or laparotomy were compared by use of Fisher's exact test or the Student t test. Recurrence-free and overall survival was calculated by use of the Kaplan-Meier method. Stratified analyses were performed with the log-rank test for factors affecting survival (surgical stage, histologic study, and grade).
  
  
  RESULTS
  Sixty-seven and 127 women were treated with laparoscopy and laparotomy, respectively. Median follow-up was 36.3 months for the laparoscopy group and 29.6 months for the laparotomy group. The complication rates in the 2 groups were comparable. Women undergoing laparoscopy had shorter hospital stay and less morbidity related to infection. The 2- and 5-year estimated recurrence-free survival rates for the laparoscopy and laparotomy groups (93 % vs 91.7% and 88.5% vs 85%, respectively), as well as the overall 2- and 5-year survival rates (100% vs 99.2% and 100% vs 97%, respectively) were similar.
  
  
  CONCLUSIONS
  Laparoscopic surgery in women with early-stage endometrial carcinoma resulted in survival rates similar to laparotomy, although a small sample size precludes definitive conclusions. A larger randomized comparison of the 2 techniques is needed to validate these findings.
authors.affiliation: Division of Gynecologic Oncology, The Mount Sinai School of Medicine, New York, New York 10029, USA. Farr.Nezhat@mssm.edu
authors.forename: Farr
authors.initials: F
authors.lastname: Nezhat
authors.forename: Jyoti
authors.initials: J
authors.lastname: Yadav
authors.forename: Jamal
authors.initials: J
authors.lastname: Rahaman
authors.forename: Herbert
authors.initials: H
authors.lastname: Gretz
authors.forename: Carmel
authors.initials: C
authors.lastname: Cohen
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D000075202:Contraindications; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis