Minimally invasive surgery feasible for nonendometroid endometrial cancers

Minimally invasive surgery for nonendometrioid endometrial cancer performs comparably as open surgery, yielding similar survival outcomes, a recent study has found.

Researchers conducted a retrospective, multi-institutional study including 113 patients, of whom 57 underwent minimally invasive surgery and 56 open surgery. Oncologic outcomes assessed included survival, recurrence rate, and sites of recurrence.

Over a median follow-up of 36 months, 15 patients in the minimally invasive group had tumour recurrence, yielding a rate of 26.3 percent. This figure was significantly lower compared with the open surgery group, in which recurrence occurred in 27 patients (48.2 percent) over a median follow-up of 41 months.

Stratifying recurrences according to stage and site revealed no significant between-group differences, suggesting that the type of surgical intervention had no impact on the pattern of cancer recurrence.

Minimally invasive surgery likewise seemed to be superior to open surgery in terms of survival, with corresponding mortality rates of 17.5 percent and 41.1 percent (p=0.007).

Kaplan-Meier curves confirmed that patients who had undergone minimally invasive surgery had significantly better disease-free (hazard ratio [HR], 2.181, 95 percent confidence interval [CI], 1.173–4.055) and overall (HR, 2.214, 95 percent CI, 1.101–4.451) survival. Multivariate analysis likewise confirmed the beneficial effect of minimally invasive surgery regarding disease-free survival, though failing to reach significance (odds ratio, 0.698, 95 percent CI, 0.353–1.381).

“When minimally invasive surgery is managed by expert surgeons, nonendometrioid histological subtypes should not be considered a contraindication,” the researchers said. “Further well-designed randomized studies are required to validate these results.”