Effect of surgical approach on risk of recurrence after vaginal brachytherapy in early-stage high-intermediate risk endometrial cancer

Philp, Lauren; Tannenbaum, Sora; Haber, Hilary; Saini, Aman; Laurent, Jessica St.; James, Kaitlyn; Feltmate, Colleen M.; Russo, Andrea; Growdon, Whitfield B.

doi:10.1016/j.ygyno.2020.12.003

Cited by 8 publications

(2 citation statements)

References 26 publications

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“… 39 , 40 Laparoscopic uterine extraction, as an emerging surgical modality for the treatment of EC, has significant advantages over traditional OH and has developed quite rapidly; some large hospitals have even carried out robotic laparoscopic surgical modalities and achieved favourable results. 41 However, Philp et al found that compared with open surgery, LH had a higher risk of recurrence in intermediate‐ and high‐risk patients 42 , 43 , 44 ; thus, the application of LH for EC has been challenged. As a result, comparing the clinical efficacy of LH and OH for EC is imperative to provide objective experimental data to assist clinicians in developing safer surgical protocols for patients with EC and improve their overall survival.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta‐analysis

Yang,

Zhou

2023

International Wound Journal

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This meta‐analysis aimed to compare laparoscopic hysterectomy (LH) and open hysterectomy (OH) in terms of surgical site wound infection, length of hospital stay, and postoperative complications in patients with endometrial cancer (EC). PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched for studies on OH and LH for EC published between 2008 and July 2023, in any language. The literature was screened according to the inclusion and exclusion criteria, and the quality of the included case–control studies was assessed using the Newcastle‐Ottawa Scale. Data were collated and analysed using Stata 17.0 software. A total of 1245 articles were screened according to the search strategy, and ultimately 15 studies were included in this meta‐analysis, with a total of 1606 patients with EC, of which 751 were treated with LH and 855 with OH. The results showed that the rate of postoperative wound infection was significantly higher (OR: 0.290; 95% CI: 0.169–0.496, p < 0.001), the length of hospital stay was significantly longer (SMD: −1.976, 95% CI: −2.669 to −1.283, p < 0.001), and the incidence of postoperative complications was significantly higher (OR: 0.366; 95% CI: 0.280–0.478, p < 0.001) in the OH group than in the LH group. This study showed that LH was superior to OH for the treatment of EC and is associated with a lower rate of wound infection, shorter length of hospitalisation, and a reduced risk of complications. Thus, our findings support the choice of LH over OH for EC.

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Section: Discussionmentioning

confidence: 99%

Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta‐analysis

Yang,

Zhou

2023

International Wound Journal

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“…Cervical involvement was a higher risk of recurrence in patients with intermediate-risk diseases [ 138 ]. In patients with high-intermediate risk tumors, minimally invasive surgery was associated with a shorter time to and a higher risk of recurrence [ 139 ]. In high-grade endometrial cancers, extracting a large uterus is associated with an increased risk of intra-abdominal recurrence [ 140 ].…”

Section: Patients Treated With Minimally Invasive Surgery: Can Adjuva...mentioning

confidence: 99%

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Otsuka

2022

Cancers

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Endometrial cancer is the most common gynecological tract malignancy in developed countries, and its incidence has been increasing globally with rising obesity rates and longer life expectancy. In endometrial cancer, extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. In this review, I discuss the characteristics of lymph node metastasis, the methods of lymph node assessment, and the therapeutic benefits of systematic lymphadenectomy in patients with intermediate- and high-risk endometrioid endometrial carcinoma.

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Operative Therapie des Endometriumkarzinoms

et al. 2022

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Effect of surgical approach on risk of recurrence after vaginal brachytherapy in early-stage high-intermediate risk endometrial cancer

Cited by 8 publications

References 26 publications

Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta‐analysis

Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta‐analysis

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Operative Therapie des Endometriumkarzinoms

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