Giorgia Monterossi1, Fabio Ghezzi2, Enrico Vizza3, Gian Franco Zannoni4, Stefano Uccella2, Giacomo Corrado3, Stefano Restaino5, Lorena Quagliozzi1, Jvan Casarin2, Giorgia Dinoi1, Giovanni Scambia1, Francesco Fanfani6. 1. Division of Gynecologic Oncology, Department of Women and Child Health, Catholic University of the Sacred Heart, Rome, Italy. 2. Department of Obstetrics and Gynecology, University of Insubria, Del Ponte Hospital, Varese, Italy. 3. Regina Elena National Cancer Institute, Rome, Italy. 4. Department of Pathology, Catholic University of the Sacred Heart, Rome, Italy. 5. Department of Medicine and Aging Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy. 6. Department of Medicine and Aging Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy. Electronic address: francesco.fanfani@unich.it.
Abstract
STUDY OBJECTIVE: To compare perioperative and survival outcomes in patients with type II endometrial cancer surgically staged by a minimally invasive surgery (MIS) approach and those surgically staged by laparotomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Catholic University of the Sacred Heart of Rome, University of Insubria, Varese and "Regina Elena" National Cancer Institute of Rome. PATIENTS: A total of 283 patients with type II endometrial cancer in clinical International Federation of Gynecology and Obstetrics stage I-II and pathological stage III with apparent early-stage disease detected on preoperative instrumental examination. INTERVENTIONS: Baseline features and perioperative data were evaluated in 142 patients who underwent hysterectomy via open surgery (laparotomy [LPT] group) and 141 patients who did so via a minimally invasive approach (MIS group). MEASUREMENTS AND MAIN RESULTS: The 2 groups were comparable in terms of baseline features and perioperative data except for operative time, which was longer in the LPT group (p < .001) and hospital stay, which was shorter in the MIS group. There were no between-group differences in pathological features, except for myometrial invasion and the rate of positive pelvic lymph nodes. Therefore, we obtained a higher number of early stages in the MIS group (p < .001). In the overall population, significant differences were observed in the recurrence rate, number, and site of relapses, with a higher recurrence rate and number in the LPT group (p < .001). Progression-free and overall survival were not significantly different in the 2 groups. CONCLUSION: Women with type II endometrial cancer submitted to MIS for hysterectomy experienced fewer complications and similar survival outcomes compared with those who underwent open surgery. When managed by an expert surgeon, a high-risk histological subtype should not be considered a contraindication for MIS. Further prospectively randomized studies are needed to definitively evaluate the safety and feasibility of MIS in early-stage type II endometrial cancer.
STUDY OBJECTIVE: To compare perioperative and survival outcomes in patients with type II endometrial cancer surgically staged by a minimally invasive surgery (MIS) approach and those surgically staged by laparotomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Catholic University of the Sacred Heart of Rome, University of Insubria, Varese and "Regina Elena" National Cancer Institute of Rome. PATIENTS: A total of 283 patients with type II endometrial cancer in clinical International Federation of Gynecology and Obstetrics stage I-II and pathological stage III with apparent early-stage disease detected on preoperative instrumental examination. INTERVENTIONS: Baseline features and perioperative data were evaluated in 142 patients who underwent hysterectomy via open surgery (laparotomy [LPT] group) and 141 patients who did so via a minimally invasive approach (MIS group). MEASUREMENTS AND MAIN RESULTS: The 2 groups were comparable in terms of baseline features and perioperative data except for operative time, which was longer in the LPT group (p < .001) and hospital stay, which was shorter in the MIS group. There were no between-group differences in pathological features, except for myometrial invasion and the rate of positive pelvic lymph nodes. Therefore, we obtained a higher number of early stages in the MIS group (p < .001). In the overall population, significant differences were observed in the recurrence rate, number, and site of relapses, with a higher recurrence rate and number in the LPT group (p < .001). Progression-free and overall survival were not significantly different in the 2 groups. CONCLUSION:Women with type II endometrial cancer submitted to MIS for hysterectomy experienced fewer complications and similar survival outcomes compared with those who underwent open surgery. When managed by an expert surgeon, a high-risk histological subtype should not be considered a contraindication for MIS. Further prospectively randomized studies are needed to definitively evaluate the safety and feasibility of MIS in early-stage type II endometrial cancer.
Authors: Nicole Concin; Carien L Creutzberg; Ignace Vergote; David Cibula; Mansoor Raza Mirza; Simone Marnitz; Jonathan A Ledermann; Tjalling Bosse; Cyrus Chargari; Anna Fagotti; Christina Fotopoulou; Antonio González-Martín; Sigurd F Lax; Domenica Lorusso; Christian Marth; Philippe Morice; Remi A Nout; Dearbhaile E O'Donnell; Denis Querleu; Maria Rosaria Raspollini; Jalid Sehouli; Alina E Sturdza; Alexandra Taylor; Anneke M Westermann; Pauline Wimberger; Nicoletta Colombo; François Planchamp; Xavier Matias-Guiu Journal: Virchows Arch Date: 2021-02 Impact factor: 4.064
Authors: Giacomo Corrado; Francesca Ciccarone; Francesco Cosentino; Francesco Legge; Andrea Rosati; Martina Arcieri; Luigi Carlo Turco; Camilla Certelli; Alex Federico; Enrico Vizza; Francesco Fanfani; Giovanni Scambia; Gabriella Ferrandina Journal: J Cancer Res Clin Oncol Date: 2020-09-03 Impact factor: 4.553
Authors: Sang Il Kim; Dong Choon Park; Sung Jong Lee; Ji Geun Yoo; Min Jong Song; Chan Joo Kim; Hae Nam Lee; Joo Hee Yoon Journal: Int J Med Sci Date: 2021-01-01 Impact factor: 3.738