Safety of minimally invasive surgery in early-stage endometrial cancer: a systematic Retrospective analysis based on 2023 FIGO staging system
Menée à l'aide de données portant sur 382 patientes atteintes d’un cancer de l’endomètre de stade précoce (durée médiane de suivi : 81,8 mois), cette étude analyse l’efficacité, du point de vue de la survie sans maladie et de la survie globale, et la sécurité d'une chirurgie mini-invasive (voie laparoscopique) par rapport à une laparotomie
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.