Christer Borgfeldt1, Erik Holmberg2, Janusz Marcickiewicz3, Karin Stålberg4, Bengt Tholander5, Elisabeth Åvall Lundqvist6, Angelique Flöter-Rådestad7, Maria Bjurberg8, Pernilla Dahm-Kähler9, Kristina Hellman10, Elisabet Hjerpe11, Preben Kjölhede12, Per Rosenberg6, Thomas Högberg13. 1. Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, SE-22185, Lund, Sweden. christer.borgfeldt@med.lu.se. 2. Region Västra Götaland, Regional Cancer Centre West, SE-41345, Gothenburg, Sweden. 3. Department of Obstetrics and Gynecology, Halland Hospital, SE-43281, Varberg, Sweden. 4. Department of Women's and Children's Health, Uppsala University, SE-75185, Uppsala, Sweden. 5. Department of Oncology, Uppsala University Hospital, SE-75185, Uppsala, Sweden. 6. Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, SE-58185, Linköping, Sweden. 7. Department of Women's and Children's Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, SE-17176, Stockholm, Sweden. 8. Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, and Department of Clinical Sciences, Lund University, SE-22185, Lund, Sweden. 9. Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, SE-41345, Gothenburg, Sweden. 10. Department of Gynecologic Cancer, Theme Cancer, Karolinska University Hospital, SE-171 76, Stockholm, Sweden. 11. Department of Gynecology and Obstetrics, Visby Hospital, SE-62155, Visby, Sweden. 12. Department of Obstetrics and Gynecology in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, SE-58185, Linköping, Sweden. 13. Department of Medical Oncology, Department of Clinical Sciences, Lund University, SE-22100, Lund, Sweden.
Abstract
BACKGROUND: The aim of this study was to analyze overall survival in endometrial cancer patients' FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). METHODS: A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. RESULTS: In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18-1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95-1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. CONCLUSION: The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.
BACKGROUND: The aim of this study was to analyze overall survival in endometrial cancerpatients' FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). METHODS: A population-based retrospective study of 7275 endometrial cancerpatients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. RESULTS: In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18-1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95-1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. CONCLUSION: The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.
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