Safety of perioperative aspirin therapy in minimally invasive endometrial cancer staging.
OBJECTIVE
To investigate if low-dose aspirin influences the risk of bleeding and hemorrhagic complications during minimally invasive surgical staging for endometrial cancer.


METHODS
Retrospective study (Canadian Task Force classification II-2.)


METHODS
University teaching hospital.


METHODS
Three hundred seventeen endometrial cancer patients undergoing laparoscopic staging.


METHODS
Laparoscopic surgical staging included total laparoscopic hysterectomy plus bilateral salpingo-oophorectomy ± retroperitoneal staging.


RESULTS
Forty-three (14%) low-dose aspirin users were compared with 274 (86%) nonaspirin users. Aspirin-treated patients were older than patients in the control group (71 [range, 50-85] vs. 64 [range, 27-92] years old, p < .001). No between-group differences in intraoperative bleeding (p = .32), hemoglobin drop (p = .91), transfusions (p = .09), and hemorrhagic complications rate (p = .58) were recorded. Aspirin users had a lower lymphadenectomy rate in comparison with patients in the control group (p = .001). However, according to a subanalysis of patients undergoing retroperitoneal staging (20 aspirin users vs. 200 patients in the control group), no differences in bleeding (p = .53), hemorrhagic complications (p = 1.0), or transfusion rate (p = .25) were observed.


CONCLUSIONS
Low-dose aspirin does not influence the risk of bleeding and hemorrhagic complications in endometrial cancer patients undergoing minimally invasive staging. Hence, the choice to continue or cease the use of low-dose aspirin should be guided only by perioperative cardiovascular risk stratification.
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. Electronic address: giorgiobogani@yahoo.it.
Giorgio
G
Bogani
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Antonella
A
Cromi
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Stefano
S
Uccella
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Maurizio
M
Serati
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Jvan
J
Casarin
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Ciro
C
Pinelli
Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy.
Fabio
F
Ghezzi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008197:Lymph Node Excision; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging; D010052:Ovariectomy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D058994:Salpingectomy
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
Antiplatelet therapy; Aspirin; Endometrial cancer; Laparoscopy; Lymphadenectomy