Laparoscopy versus laparotomy for the management of early stage endometrial cancer

Galaal, Khadra; Donkers, Hannah; Bryant, Andrew; Lopes, Alberto

doi:10.1002/14651858.cd006655.pub3

Cited by 121 publications

(116 citation statements)

References 51 publications

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“…Blood loss was lower in patients undergoing laparoscopy in an evaluable subset of patients with this variable reported, and severe postoperative adverse events were also lower in the minimally invasive group. 61 The GOG also demonstrated noninferiority of laparoscopy compared with laparotomy in the landmark randomized LAP2 trial. Patients were randomized 2:1 to laparoscopic versus open hysterectomy, BSO, and pelvic and para-aortic lymphadenectomy.…”

Section: Surgical Approachmentioning

confidence: 97%

Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

414

372

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Endometrial cancer is the most common gynecologic cancer in the United States, and its incidence is rising. Although there have been significant recent advances in our understanding of endometrial cancer biology, many aspects of treatment remain mired in controversy, including the role of surgical lymph node assessment and the selection of patients for adjuvant radiation or chemotherapy. For the subset of women with microsatellite‐instable, metastatic disease, anti– programmed cell death protein 1 immunotherapy (pembrolizumab) is now approved by the US Food and Drug Administration, and numerous trials are attempting to build on this early success.

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Section: Surgical Approachmentioning

confidence: 97%

Current recommendations and recent progress in endometrial cancer

Brooks

Fleming

Lastra

et al. 2019

CA A Cancer J Clinicians

414

372

View full text Add to dashboard Cite

show abstract

“…Additionally, laparoscopic interventions are associated with significant decreased risk of major surgical adverse events, shorter hospital stays, less pain, and faster recoveries. [32][33][34] Owing to the demonstrated oncological safety of the laparoscopic approach, 28,35 hysterectomy and bilateral salpingo-oophorectomy by this route is recommended in those patients with no contraindications to laparoscopy (e.g. large-volume uterus).…”

Section: Surgical Staging Procedures For Endometrial Cancermentioning

confidence: 99%

Cancer of the corpus uteri

Amant

Mirza

Koskas³

et al. 2018

Intl J Gynecology & Obste

318

231

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Endometrial cancer is the most common gynecological malignancy in high‐income countries. Although the overall prognosis is relatively good, high‐grade endometrial cancers have a tendency to recur. Recurrence needs to be prevented since the prognosis for recurrent endometrial cancer is dismal. Treatment tailored to tumor biology is the optimal strategy to balance treatment efficacy against toxicity. Standard treatment consists of hysterectomy and bilateral salpingo‐oophorectomy. Lymphadenectomy (with ongoing studies of sentinel node biopsy) enables identification of lymph node positive patients who need adjuvant treatment, including radiotherapy and chemotherapy. Adjuvant radiotherapy is used for Stage I–II patients with high‐risk factors and Stage III lymph node negative patients. In advanced disease, a combination of surgery to no residual disease and chemotherapy results in the best outcome. Surgery for recurrent disease is only advocated in patients with a good performance status with a relatively long disease‐free interval.

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“…Ideally, surgery should involve a minimal access technique because this has been associated with a shorter hospital stay, lower infection rate and less postoperative pain. 33,34 Importantly, the available data show no difference in survival or rates of recurrence between patients with endometrial cancer undergoing a total laparoscopic hysterectomy and those treated by laparotomy. 34,35 Compared with laparoscopy, robotic surgery may have benefits because the operating time, blood loss, hospital stay and rate of conversion to laparotomy are lower, although the cost remains prohibitive for many hospital trusts.…”

Section: Diagnosing Endometrial Cancer In Obese Womenmentioning

confidence: 99%

Endometrial cancer and obesity

Kitson

Crosbie

2019

The Obstetric & Gynaecologis

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Key content Of the 20 most common tumour types, endometrial cancer has the strongest association with obesity. Endometrial cancer should be considered in young, obese women with irregular or heavy menstrual bleeding. To reduce the risk of postoperative complications, surgery for endometrial cancer should be performed using minimal access techniques whenever possible. For women who are unfit for, or who decline, surgery, alternative treatments include progestins or radiotherapy, but these have lower efficacy and are associated with a higher risk of disease relapse. Obesity is associated with reduced overall survival following endometrial cancer because of increased cardiovascular mortality; it may also affect disease‐specific survival. Learning objectives To further understanding of the mechanisms through which obesity drives endometrial carcinogenesis. To improve understanding of the potential difficulties associated with the management of endometrial cancer in obese women. To increase knowledge of alternative treatment options for women who are unfit for, or who decline, standard endometrial cancer management. Ethical issues The number of young, premenopausal women with endometrial cancer is increasing – how should these women be managed? Should super‐obese women with endometrial cancer only be treated in cancer centres? After treating a woman's endometrial cancer, how should she be counselled her about her weight and cardiovascular disease risk?

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Laparoscopy versus laparotomy for the management of early stage endometrial cancer

Cited by 121 publications

References 51 publications

Current recommendations and recent progress in endometrial cancer

Current recommendations and recent progress in endometrial cancer

Cancer of the corpus uteri

Endometrial cancer and obesity

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