Papathemelis, Thomas and Oppermann, Helen and Grafl, Stella and Gerken, Michael and Pauer, Armin and Scharl, Sophia and Scharl, Anton and Inwald, Elisabeth and Ignatov, Atanas and Ortmann, Olaf and Klinkhammer-Schalke, Monika and Hein, Alexander and Beckmann, Matthias W. and Lux, Michael P. (2020) Long-term outcome of patients with intermediate- and high-risk endometrial cancer after pelvic and paraaortic lymph node dissection: a comparison of laparoscopic vs. open procedure. JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 146 (4). pp. 961-969. ISSN 0171-5216, 1432-1335
Full text not available from this repository. (Request a copy)Abstract
Objective The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and paraaortic lymph node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery. Methods This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan-Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250). Results We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable (p = 0.002; PSM: p = 0.016) and multivariable analyses (p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival (p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding (p = 0.108; PSM: p = 0.118). Conclusions Our study provides evidence that laparoscopic systematic lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | OPEN HYSTERECTOMY; SURGERY; WOMEN; Endometrial cancer; Pelvic and paraaortic lymphadenectomy; Laparoscopy; Laparotomy; Overall survival; Observational study; Cancer registry study |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Frauenheilkunde) Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 06 Apr 2021 07:07 |
| Last Modified: | 06 Apr 2021 07:07 |
| URI: | https://pred.uni-regensburg.de/id/eprint/45366 |
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