Feasibility, safety, and cost outcomes of laparoscopic management of early endometrial and cervical malignancy.
BACKGROUND
The role of laparoscopy in the management of early stage endometrial and cervical cancer is continuously validated by many reports throughout the world. Interestingly, such data are still unavailable in many European countries, as it is in Greece. In this prospective study, we report on initial feasibility, safety, and cost outcomes of laparoscopic management of early stage endometrial and cervical cancer, recently introduced in our country.


METHODS
This was a prospective pilot study comprising a case series. Patients referred to a tertiary referral medical center with a recent diagnosis of endometrial or cervical cancer were evaluated, and those meeting inclusion criteria were offered laparoscopic surgical staging.


RESULTS
Out of 64 patients evaluated, 17 with early clinical stage endometrial cancer and 8 with early clinical stage cervical cancer underwent successful laparoscopic staging. Mean patient age was 61.6 and 39.2 years, mean BMI was 32.3 and 24.1kg/m(2), mean operative time was 243 and 284 minutes, mean estimated blood loss was 190mL and 270mL, mean lymph node count was 27.2 and 29.1, and mean hospital stay was 2 and 3 days for endometrial and cervical cancer cases, respectively. The overall costs for the procedures performed were not greater than their laparotomy counterpart. One intraoperative complication was managed laparoscopically, and 2 cases occurred of postoperative lymphocyst formation.


CONCLUSIONS
To our knowledge, this is the first study of laparoscopic management of early endometrial and cervical cancer in Greece. Our preliminary data support the feasibility, safety, and cost effectiveness of laparoscopic management of early endometrial and cervical cancer in our country and are in accordance with series reported in the international literature.
Hilaris
Georgios E
GE
Adjunct Clinical Instructor of Obstetrics and Gynecology, Department of Obstetrics & Gynecology and Center for Special Minimally Invasive and Robotic Surgery, Stanford University School of Medicine, Stanford, California, USA. ghilaris@stanford.edu
Tsoubis
Thomas
T
Konstantopoulos
Vasilios
V
Pavlakis
Kitty
K
D000328:Adult; D003365:Costs and Cost Analysis; D016889:Endometrial Neoplasms / Q000191:economics / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods / Q000592:standards; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D011446:Prospective Studies; D012449:Safety; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*