There appear to be no significant outcome differences in patients with endometrial cancer (EC) treated with a laparoscopic approach and those who underwent a laparotomy, according to a recently published study in the Journals of Gynecology and Obstetrics of India.
Surgical treatment is the standard of care for non metastatic EC, but there are questions regarding the best surgical approach. A laparotomy approach or open surgery involves making a complete incision, while a laparoscopic approach or minimally invasive surgery only requires some small incisions in the abdomen using a camera and specialized instruments.
Although laparoscopy is associated with less blood loss, shorter recovery times and fewer postoperative complications, there are concerns regarding the efficacy of laparoscopy in completely removing cancerous tissue. A relatively recent clinical trial showed that a laparoscopic approach is associated with lower disease-free survival and overall survival.
In this context, the authors aimed to compare overall survival and progression free survival (PFS) in patients undergoing laparoscopy and laparotomy. The retrospective study included data from 41 patients of which 21 underwent laparotomy and 20 laparoscopy.
The median tumor size of the included was 5 cm, and most patients had stage III disease. The results showed that the average 5-year overall survival (OS) was 61%, with 52.4% in the laparotomy group and 70% in the laparoscopy group . PFS at 5 years was 82.9% overall, with 85.7% in the laparotomy group and 80% in the laparoscopy group . Recurrence occurred in 7 patients, with no statistically significant difference between groups.
The authors concluded that both surgical approaches yielded similar survival and recurrence outcomes in EC patients with cervical involvement.
“In this study, although our patient number was small, we compared laparoscopy and laparotomy in the treatment of EEC with cervical involvement and no statistical difference was found. In this context, studies with larger patient numbers are needed,” the authors concluded.
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