title: Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a Gynecologic Oncology Group study.
abstract: OBJECTIVE
  The study's objective was to compare the quality of life (QoL) of patients with endometrial cancer undergoing surgical staging via laparoscopy versus laparotomy.
  
  
  METHODS
  The first 802 eligible patients (laparoscopy, n = 535; laparotomy, n = 267) participated in the QoL study in a Gynecologic Oncology Group (GOG) randomized trial of laparoscopy versus laparotomy (GOG 2222). Patients completed QoL assessments at baseline; at 1, 3, and 6 weeks; and at 6 months postsurgery.
  
  
  RESULTS
  In an intent-to-treat analysis, laparoscopy patients reported significantly higher Functional Assessment of Cancer Therapy-General (FACT-G) scores (P = .001), better physical functioning (P = .006), better body image (BI; P < .001), less pain (P < .001) and its interference with QoL (P < .001), and an earlier resumption of normal activities (P = .003) and return to work (P = .04) over the 6-week postsurgery period, as compared with laparotomy patients. However, the differences in BI and return to work between groups were modest, and the adjusted FACT-G scores did not meet the minimally important difference (MID) between the two surgical arms over 6 weeks. By 6 months, except for better BI in laparoscopy patients (P < .001), the difference in QoL between the two surgical techniques was not statistically significant.
  
  
  CONCLUSIONS
  Although the FACT-G did not show a MID between the two surgical groups, and only modest differences in return to work and BI were found between the two groups, statistically significantly better QoL across many parameters in the laparoscopy arm at 6 weeks provides modest support for the QoL advantage of using laparoscopy to stage patients with early endometrial cancer.
authors.affiliation: Division of Women's Cancers, Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA. alice_kornblith@dfci.harvard.edu
authors.forename: Alice B
authors.initials: AB
authors.lastname: Kornblith
authors.forename: Helen Q
authors.initials: HQ
authors.lastname: Huang
authors.forename: Joan L
authors.initials: JL
authors.lastname: Walker
authors.forename: Nick M
authors.initials: NM
authors.lastname: Spirtos
authors.forename: Jacob
authors.initials: J
authors.lastname: Rotmensch
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011788:Quality of Life; D011795:Surveys and Questionnaires