Safety of minimally invasive surgery in early-stage endometrial cancer: A systematic Retrospective analysis based on 2023 FIGO staging system☆

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-03-23 DOI:10.1016/j.ejso.2025.109997

Yuzheng Gan , Wei Xu , Shuang Liang , Chenyu Zhou, Lequn Li, Yincheng Teng, Xiaolu Zhu, Zhihong Ai

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Abstract

Objective

To evaluate the efficacy and safety of minimally invasive surgery in the management of early-stage endometrial cancer.

Method

This study involved a retrospective analysis of clinical data and prognosis for 382 patients diagnosed with early-stage endometrial cancer (stage I and II) who underwent either laparoscopy or laparotomy at Shanghai Sixth People's Hospital between June 2011 and November 2022. The postoperative pathological diagnoses were based on 2023 FIGO staging system.

Results

A total of 189 patients underwent laparotomy and 193 patients underwent laparoscopic surgery. The intraoperative blood loss and postoperative complications (pulmonary embolism, pulmonary infection, intestinal obstruction, suboptimal healing or infection of surgical incision) rates in laparoscopy group was significantly lower than that in laparotomy group (P < 0.05). Regarding long-term prognosis (mean follow-up duration of 81.8 ± 41.1 months), there were no significant differences in DFS (Disease-Free Survival) and OS (Overall Survival) between two groups (P > 0.05). By integrating the new FIGO staging with risk factors for stratified analysis, the results still indicated that there were no significant differences in DFS or OS between laparoscopy group and laparotomy group across all risk stratification (P > 0.05).

Conclusions

In the management of early-stage EC, laparoscopy significantly reduces intraoperative blood loss and postoperative complication rates, which facilitate patient recovery without adversely affecting recurrence or survival outcomes.

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微创手术治疗早期子宫内膜癌的安全性：基于2023年FIGO分期系统的回顾性分析

目的评价微创手术治疗早期子宫内膜癌的有效性和安全性。方法回顾性分析2011年6月至2022年11月在上海市第六人民医院行腹腔镜或开腹手术的382例早期子宫内膜癌（I期和II期）患者的临床资料和预后。术后病理诊断依据2023 FIGO分期系统。结果189例患者行剖腹手术，193例患者行腹腔镜手术。腹腔镜组术中出血量及术后并发症（肺栓塞、肺部感染、肠梗阻、手术切口愈合不佳或感染）发生率显著低于开腹组(P <；0.05)。长期预后方面（平均随访时间81.8±41.1个月），两组患者无病生存期（DFS）和总生存期（OS）比较差异无统计学意义(P >；0.05)。通过将新的FIGO分期与危险因素相结合进行分层分析，结果仍然表明腹腔镜组与开腹组在所有危险分层中的DFS或OS均无显著差异(P >；0.05)。结论腹腔镜治疗早期EC可显著减少术中出血量和术后并发症发生率，促进患者康复，且不影响复发或生存结果。

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

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.