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 ( 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.

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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.


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