Analysis of survival after laparoscopic management of endometrial cancer.
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Publication Details
Output type: Journal article
Author list: Nezhat, Yadav, Rahaman, Gretz, Cohen
Publisher: Elsevier
Publication year: 2008
Journal: Journal of Minimally Invasive Gynecology (1553-4650)
Volume number: 15
Issue number: 2
Start page: 181
End page: 7
Number of pages: -173
ISSN: 1553-4650
eISSN: 1553-4669
Languages: English-Great Britain (EN-GB)
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Open access status: closed
Abstract
STUDY OBJECTIVE\nTo assess the effect of laparoscopic surgery on the survival of women with early-stage endometrial cancer and to analyze the factors that affect survival.\nDESIGN\nRetrospective cohort study (Canadian Task Force classification II-2).\nSETTING\nTertiary teaching hospital.\nPATIENTS\nWomen with clinical stage I and II endometrial cancer (International Federation of Gynecology and Obstetrics staging, 1971) from January 1993 through June 2003.\nINTERVENTION\nDemographic, surgical, perioperative, and pathologic characteristics of women treated with laparoscopy or laparotomy were compared by use of Fisher's exact test or the Student t test. Recurrence-free and overall survival was calculated by use of the Kaplan-Meier method. Stratified analyses were performed with the log-rank test for factors affecting survival (surgical stage, histologic study, and grade).\nMEASUREMENTS AND MAIN RESULTS\nSixty-seven and 127 women were treated with laparoscopy and laparotomy, respectively. Median follow-up was 36.3 months for the laparoscopy group and 29.6 months for the laparotomy group. The complication rates in the 2 groups were comparable. Women undergoing laparoscopy had shorter hospital stay and less morbidity related to infection. The 2- and 5-year estimated recurrence-free survival rates for the laparoscopy and laparotomy groups (93 % vs 91.7% and 88.5% vs 85%, respectively), as well as the overall 2- and 5-year survival rates (100% vs 99.2% and 100% vs 97%, respectively) were similar.\nCONCLUSIONS\nLaparoscopic surgery in women with early-stage endometrial carcinoma resulted in survival rates similar to laparotomy, although a small sample size precludes definitive conclusions. A larger randomized comparison of the 2 techniques is needed to validate these findings.
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