Minimally invasive surgery versus open surgery in advanced stage endometrial cancer

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research Pub Date : 2024-12-03 DOI:10.1111/jog.16179

Jimin Lee, Jeeyeon Kim, Joo-Hyuk Son, Tae-Wook Kong, Jiheum Paek, Suk-Joon Chang

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引用次数: 0

Abstract

Aim

Staging surgery in early stage endometrial cancer has been shown to be feasible and safe with minimally invasive surgery (MIS) in many previous studies. However, there is limited literature on MIS's safety in advanced stages. This study aims to identify factors associated with survival in stage III endometrial cancer and investigate survival differences based on surgical approach.

Methods

Patients with stage III endometrial cancer who underwent staging surgery from March 2002 to March 2023 were included in this study. Various clinicopathological features, disease-free survival (DFS), and overall survival (OS) were evaluated.

Results

Among the 79 patients included in this study, 20 patients underwent MIS (25.3%) and 59 patients underwent open surgery (74.7%). The open surgery group had a higher prevalence of aggressive histology, a higher median pretreatment CA-125 level, and a greater number of harvested lymph nodes compared to the MIS group. Five-year OS and DFS was higher in the open surgery group than in the MIS group (DFS: 67.9% vs. 59.9%, p = 0.046; OS: 74.3 vs. 50.6%, p = 0.008). In multivariate analysis, younger than 55 years old (OR, 2.778; 95% CI, 1.078–7.156; p = 0.034), and open surgery (OR, 3.671; 95% CI, 1.581–8.522; p = 0.002) was related to improved OS.

Conclusions

Open staging surgery showed better survival outcomes when compared to MIS in stage III endometrial cancer patients in our study. For patients who are older than 55 years old and have aggressive histology in endometrial biopsy, considering open surgery may help improve their prognosis, even if preoperative MRI suggests early-stage endometrial cancer.

查看原文本刊更多论文

微创手术与开放手术治疗晚期子宫内膜癌的比较。

目的：在早期子宫内膜癌的分期手术中，微创手术（MIS）已被证明是可行和安全的。然而，关于MIS在晚期安全性的文献有限。本研究旨在确定与III期子宫内膜癌生存相关的因素，并探讨基于手术入路的生存差异。方法：本研究纳入2002年3月至2023年3月行分期手术的III期子宫内膜癌患者。评估各种临床病理特征、无病生存期（DFS）和总生存期（OS）。结果：本研究纳入的79例患者中，20例患者行MIS(25.3%)， 59例患者行开放手术（74.7%）。与MIS组相比，开放手术组具有更高的侵袭性组织学患病率，更高的预处理CA-125中位数水平，以及更多的淋巴结清扫。开放手术组5年OS和DFS高于MIS组(DFS: 67.9% vs. 59.9%, p = 0.046；OS: 74.3 vs 50.6%, p = 0.008)。在多变量分析中，年龄小于55岁(OR, 2.778；95% ci, 1.078-7.156；p = 0.034)，开放手术(OR, 3.671；95% ci, 1.581-8.522；p = 0.002)与OS改善有关。结论：在我们的研究中，与MIS相比，开放分期手术在III期子宫内膜癌患者中显示出更好的生存结果。对于年龄大于55岁且子宫内膜活检呈侵袭性组织学的患者，即使术前MRI提示为早期子宫内膜癌，考虑开放手术可能有助于改善其预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Obstetrics and Gynaecology Research 医学-妇产科学

CiteScore

3.10

自引率

0.00%

发文量

376

审稿时长

3-6 weeks

期刊介绍： The Journal of Obstetrics and Gynaecology Research is the official Journal of the Asia and Oceania Federation of Obstetrics and Gynecology and of the Japan Society of Obstetrics and Gynecology, and aims to provide a medium for the publication of articles in the fields of obstetrics and gynecology. The Journal publishes original research articles, case reports, review articles and letters to the editor. The Journal will give publication priority to original research articles over case reports. Accepted papers become the exclusive licence of the Journal. Manuscripts are peer reviewed by at least two referees and/or Associate Editors expert in the field of the submitted paper.