Oncologic safety of laparoscopic surgery for women with apparent early‐stage uterine serous carcinoma: A multi‐institutional retrospective cohort study

Abstract

Cancer of the endometrium is the most common malignancy of the female reproductive system in developed countries, its incidence and associated mortality are increasing because rates of obesity have risen. [1][2][3] Two broad histologic types of endometrial cancer were proposed by Bokhman in 1983. 4 Type I tumors, affecting about 80% of cases, are mediated primarily by hyperestrogenism and are generally associated with a good prognosis. 2,5 Type II endometrial cancers, in contrast, have no exact pathogenesis. 2,5 Histologically, type II tumors are poorly differentiated or undifferentiated, most commonly serous and clear cell subtypes. 6 They are clinically aggressive, usually present at advanced stages, are associated with poor prognosis, and have a higher risk of recurrence. 6,7 Uterine serous carcinoma (USC) is the most common histologic type of type II endometrial cancer, accounting for about 80% of non-endometrioid endometrial cancer and approximately 40% of all endometrial cancer-related mortality. 8

Survival after laparoscopy versus laparotomy for apparent early-stage uterine clear cell carcinoma: Results of a large multicenter cohort study

“…So far, some retrospectively designed studies about the oncological safety of minimally invasive surgery for type II EC have been published. Including 295 patients from four Chinese teaching hospitals, the study conducted by Xu et al found that for apparent early-stage uterine serous carcinoma, the approach of surgical staging was not an independent prognostic factor for oncological outcomes (laparoscopy versus open surgery: for DFS, aHR=1.16, 95% CI=0.63-2.12, P=0.636; for OS, aHR=1.11, 95% CI=0.52-2.38, P=0.794) (24). Comparing DFS between minimally invasive surgery and laparotomic surgery in patients with high-risk EC, the study conducted by Segarra-Vidal et al included 626 patients (25).…”