Gynecologic Oncology Department, Medical Faculty, Çukurova University, Adana 01380, Turkey.
Gynecologic Oncology Department, Medical Faculty, Ankara University, Ankara 06100, Turkey.
Curr Oncol. 2021 Oct 29;28(6):4328-4340. doi: 10.3390/curroncol28060368.
This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high-intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high-intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high-intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high-intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high-intermediate- and high-risk endometrial cancer cases.
本研究旨在比较 2016 年 ESMO-ESGO-ESTRO 风险分类系统指导下的开腹手术和腹腔镜手术治疗子宫内膜癌的长期肿瘤学结果，特别关注中高危和高危类别。使用 2005 年 1 月至 2016 年 1 月的多中心数据库，根据手术途径（开腹手术与腹腔镜手术）比较了 2745 例子宫内膜癌病例的无病生存率和总生存率。根据 2016 年 ESMO-ESGO-ESTRO 风险分类系统，将中高危和高危患者定义为，并分析其生存率差异。在 2745 例患者中，1743 例（63.5%）接受开腹手术，其余接受腹腔镜手术。开腹组中高危和高危子宫内膜癌病例总数为 734 例（45%），腹腔镜组为 307 例（30.7%）。在低危、中危、中高危和高危子宫内膜癌中，腹腔镜组与开腹组相比，无病生存率和总生存率无统计学差异。总之，无论子宫内膜癌的风险类别如何，腹腔镜手术的长期肿瘤学结果都与开腹手术相当。我们的研究结果令人鼓舞，可以考虑对中高危和高危子宫内膜癌病例进行腹腔镜手术。
