title: Laparoscopic surgery for endometrial cancer: a review.
abstract: Uterine cancer is the fourth most common cancer in Canadian women, with an estimated 4200 new cases and 790 disease-related deaths in 2008. We investigated the domains that are important for further implementation of minimally invasive surgery for the management of endometrial cancer by performing a literature review to assess the available data on overall and disease-free survival in laparoscopic versus open surgery. We also investigated the influence of patient- related factors, surgical factors, quality of life, and cost implications. Among the 23 articles reviewed, five were randomized controlled trials (RCTs), four were prospective reviews, and 14 were retrospective reviews. The RCTs showed no difference in overall and disease-free survival for patients with endometrial cancer who had undergone laparoscopic hysterectomy compared with open surgery. Morbid obesity is a limiting factor for the feasibility of complete laparoscopic staging. Laparoscopy seems to decrease complications and decrease blood loss. It also shortens hospital stay, with improved short-term quality of life and cosmesis, while yielding similar lymph node counts. Overall, laparoscopy is cost-effective, because the increased operation cost of laparoscopy is offset by the shorter hospital stay and faster return to work. On the basis of currently available data, patients with endometrial cancer should be offered minimally invasive surgery as part of their treatment for endometrial cancer whenever possible.
authors.affiliation: Hamilton Health Sciences-Juravinski Cancer Centre, McMaster University, Hamilton ON.
authors.forename: Jan
authors.initials: J
authors.lastname: Hauspy
authors.affiliation: The Credit Valley Hospital, University of Toronto, Toronto ON.
authors.forename: Waldo
authors.initials: W
authors.lastname: Jiménez
authors.affiliation: University Health Network, University of Toronto, Toronto ON.
authors.forename: Barry
authors.initials: B
authors.lastname: Rosen
authors.affiliation: Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal QC.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
authors.affiliation: Ottawa Hospital, University of Ottawa, Ottawa ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Fung-Kee-Fung
authors.affiliation: L'Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec QC.
authors.forename: Marie
authors.initials: M
authors.lastname: Plante
mesh_terms: D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy; D007902:Length of Stay; D011788:Quality of Life