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Laparoscopy Versus Laparotomy in the Treatment of High-Risk Endometrial Cancer: A Propensity Score Matching Analysis.

Gao H, Zhang Z - Medicine (Baltimore) (2015)

Bottom Line: The laparoscopy cohort has less blood loss (107 mL vs.414 mL, P < 0.01), shorter hospital stay (14.7 days vs. 17.7 days, P = 0.02) and significant fewer intraoperative complications (6.2% vs. 25.9%, P < 0.01).The pelvic lymph nodes dissected by laparoscopy (16.4) were significant less than that dissected by laparotomy (21.9).There was no significant difference in overall survival (P = 0.97).Laparoscopy is as effective as laparotomy in the long term and can be safely carried out in patients with high-risk EC for surgery treatment.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
The aim of this study was to compare the long-term safety and efficacy of laparoscopic surgery and laparotomy for high-risk endometrial cancer (EC).A retrospective analysis based on our decade of clinical data of patients with high-risk EC who were comprehensively surgically staged by laparotomy or laparoscopy was performed. The surgical outcomes were compared between different approaches using propensity score matching (PSM).Eighty-one pairs of patients from the initial 220 enrolled ones were matched by PSM. The mean operative time is similar between laparotomy and laparoscopy groups (258 minutes vs. 253 minutes). The laparoscopy cohort has less blood loss (107 mL vs.414 mL, P < 0.01), shorter hospital stay (14.7 days vs. 17.7 days, P = 0.02) and significant fewer intraoperative complications (6.2% vs. 25.9%, P < 0.01). The pelvic lymph nodes dissected by laparoscopy (16.4) were significant less than that dissected by laparotomy (21.9). The 5- and 10-year survival rate for laparotomy were 89.2% and 75.8% compared with 85.3% and 85.3% for the laparoscopy. There was no significant difference in overall survival (P = 0.97).Laparoscopy is as effective as laparotomy in the long term and can be safely carried out in patients with high-risk EC for surgery treatment.

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Related in: MedlinePlus

Overall survival. It showed that no significant difference between laparotomy and laparoscopy cohorts (75.8% vs. 85.3%, P = 0.97).
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Figure 1: Overall survival. It showed that no significant difference between laparotomy and laparoscopy cohorts (75.8% vs. 85.3%, P = 0.97).

Mentions: Clinical outcome of 2 groups was shown in Table 4. The median follow-up was 45 months (rang 5–176). During the follow-up time, there were 16 (9.9%) recurrences which were similar between the 2 treatment cohorts, 7 (8.6%) were observed in laparotomy group at peritoneal, liver, lung, vaginal, and abdominal incision versus 9 (11.1%) in laparoscopy group at peritoneal, liver, lung, and vaginal. No port-site metastases were observed in laparoscopy cohort. Twenty patients died, 11 in the laparotomy group and 9 in the laparoscopy group. The Kaplan–Meier estimate for survival rate in laparotomy and laparoscopy at 5 years was 89.2%, 85.3% and at 10 years was 75.8%, 85.3%, respectively. No statistically significant difference was found between the 2 groups when OS was compared (P = 0.97) (Figure 1).


Laparoscopy Versus Laparotomy in the Treatment of High-Risk Endometrial Cancer: A Propensity Score Matching Analysis.

Gao H, Zhang Z - Medicine (Baltimore) (2015)

Overall survival. It showed that no significant difference between laparotomy and laparoscopy cohorts (75.8% vs. 85.3%, P = 0.97).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554115&req=5

Figure 1: Overall survival. It showed that no significant difference between laparotomy and laparoscopy cohorts (75.8% vs. 85.3%, P = 0.97).
Mentions: Clinical outcome of 2 groups was shown in Table 4. The median follow-up was 45 months (rang 5–176). During the follow-up time, there were 16 (9.9%) recurrences which were similar between the 2 treatment cohorts, 7 (8.6%) were observed in laparotomy group at peritoneal, liver, lung, vaginal, and abdominal incision versus 9 (11.1%) in laparoscopy group at peritoneal, liver, lung, and vaginal. No port-site metastases were observed in laparoscopy cohort. Twenty patients died, 11 in the laparotomy group and 9 in the laparoscopy group. The Kaplan–Meier estimate for survival rate in laparotomy and laparoscopy at 5 years was 89.2%, 85.3% and at 10 years was 75.8%, 85.3%, respectively. No statistically significant difference was found between the 2 groups when OS was compared (P = 0.97) (Figure 1).

Bottom Line: The laparoscopy cohort has less blood loss (107 mL vs.414 mL, P < 0.01), shorter hospital stay (14.7 days vs. 17.7 days, P = 0.02) and significant fewer intraoperative complications (6.2% vs. 25.9%, P < 0.01).The pelvic lymph nodes dissected by laparoscopy (16.4) were significant less than that dissected by laparotomy (21.9).There was no significant difference in overall survival (P = 0.97).Laparoscopy is as effective as laparotomy in the long term and can be safely carried out in patients with high-risk EC for surgery treatment.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Obstetrics and Gynecology, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing, China.

ABSTRACT
The aim of this study was to compare the long-term safety and efficacy of laparoscopic surgery and laparotomy for high-risk endometrial cancer (EC).A retrospective analysis based on our decade of clinical data of patients with high-risk EC who were comprehensively surgically staged by laparotomy or laparoscopy was performed. The surgical outcomes were compared between different approaches using propensity score matching (PSM).Eighty-one pairs of patients from the initial 220 enrolled ones were matched by PSM. The mean operative time is similar between laparotomy and laparoscopy groups (258 minutes vs. 253 minutes). The laparoscopy cohort has less blood loss (107 mL vs.414 mL, P < 0.01), shorter hospital stay (14.7 days vs. 17.7 days, P = 0.02) and significant fewer intraoperative complications (6.2% vs. 25.9%, P < 0.01). The pelvic lymph nodes dissected by laparoscopy (16.4) were significant less than that dissected by laparotomy (21.9). The 5- and 10-year survival rate for laparotomy were 89.2% and 75.8% compared with 85.3% and 85.3% for the laparoscopy. There was no significant difference in overall survival (P = 0.97).Laparoscopy is as effective as laparotomy in the long term and can be safely carried out in patients with high-risk EC for surgery treatment.

Show MeSH
Related in: MedlinePlus