title: Conversion in endometrial cancer patients scheduled for laparoscopic staging: a large multicenter analysis: conversions and endometrial cancer.
abstract: BACKGROUND
  Data on patients with endometrial cancer converted to laparotomy are totally lacking. The aim of the present study was to evaluate surgical and oncological outcomes in patients with endometrial cancer scheduled for laparoscopic staging but converted to laparotomy.
  
  
  METHODS
  Data of consecutive patients who had undergone surgery for staging endometrial cancer in seven Italian centers were reviewed. Patients' characteristics and surgical and oncological data were noted and analyzed according to surgery, i.e. laparotomy, laparoscopy, and laparoscopy converted to laparotomy.
  
  
  RESULTS
  Seventy-one out of 512 (13.9 %) patients scheduled to laparoscopy were converted to laparotomy for reasons related to anesthesiology [38/71 (53.5 %)] or surgery [33/71 (46.5 %)]. The conversion rate varied among stages [41/460 (8.9 %), 13/27 (48.1 %), 17/25 (68.0 %) in patients with stage I, II, and endometrial cancers, respectively]. Significant (P < 0.05) differences among groups were detected in patients' age, body mass index and previous pelvic surgery, and in the distribution of stages and histotype of endometrial cancers. The Kaplan-Meier procedure showed that the cumulative probability of first recurrence (P = 0.089, 0.590 and 0.084 for stage I, II and III, respectively) and of death (P = 0.108, 0.567 and 0.372 for stage I, II and III, respectively) categorized by stages did not attain statistical significance by log-rank testing after correction for confounding factors.
  
  
  CONCLUSIONS
  The surgical and oncological outcomes of converted patients are no different from those of patients staged successfully with laparoscopy or with laparotomy. The conversion to laparotomy should be not considered per se a complication.
authors.affiliation: Obstetrics and Gynecology Unit, IRCCS - Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123, Reggio Emilia, Italy, stefanopalomba@tin.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
authors.forename: Angela
authors.initials: A
authors.lastname: Falbo
authors.forename: Vincenzo Dario
authors.initials: VD
authors.lastname: Mandato
authors.forename: Gianluca
authors.initials: G
authors.lastname: Annunziata
authors.forename: Emilio
authors.initials: E
authors.lastname: Lucia
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.forename: Letizia
authors.initials: L
authors.lastname: Zannoni
authors.forename: Renato
authors.initials: R
authors.lastname: Seracchioli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Giorda
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: La Sala
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
authors.forename: Massimo
authors.initials: M
authors.lastname: Franchi
mesh_terms: D000328:Adult; D000368:Aged; D061887:Conversion to Open Surgery; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors