Abdominal vs Laparoscopic Hysterectomy: Outcomes Similar for Endometrial Cancer

For stage I endometrial cancer, total abdominal hysterectomy and total laparoscopic hysterectomy resulted in similar OS.
For stage I endometrial cancer, total abdominal hysterectomy and total laparoscopic hysterectomy resulted in similar OS.

In women with stage I endometrial cancer, total abdominal hysterectomy and total laparoscopic hysterectomy resulted in similar disease-free survival (DFS) rates at 4.5 years and no difference in overall survival rates, according to results from a clinical trial (ClinicalTrials.gov identifier: NCT00096408).

Typical treatment of endometrial cancer involves hysterectomy; however, more than 1 surgical approach to hysterectomy exists.

This multinational, randomized equivalence trial conducted from October 2005 to June 2010 compared total laparoscopic hysterectomy to total abdominal hysterectomy.

For the study, 760 women with stage I endometrial cancer in Australia, New Zealand, and Hong Kong were randomized to either laparoscopic (n = 407) or abdominal (n = 353) hysterectomy.

Disease-free survival, measured as the time between surgery and the date of first recurrence, was 81.6% in the laparoscopic arm and 81.3% in the abdominal arm at 4.5 years follow-up. DFS rate meet criteria for equivalence (0.2% [95% CI, –5.5% to 6.1%]; P =.007) between the 2 arms.

Differences in secondary outcomes — recurrence of endometrial cancer or overall survival — were not statistically significant (0.2% [95% CI, –3.7% to 4.0%]; P =.93).

The researchers conclude that these results support use of laparoscopic hysterectomy in women with stage I endometrial cancer.

Reference

1. Janda M, Gebski V, Davies LC, et al. Effect of total laparoscopic hysterectomy vs total abdominal hysterectomy on disease-free survival among women with stage I endometrial cancer: a randomized clinical trial [published online March 28, 2017]. JAMA. doi:10.1001/jama.2017.2068

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