Laparoscopic Versus Laparotomy Approach in Surgical Treatment of Endometrial Cancer: Pelvic Lymphadenectomy Results

Aim: Compare the efficacy of laparoscopic versus laparotomy approach in women with early stage endometrial adenocarcinoma. Methods: Case control retrospective study of 226 women treated of early endometrial cancer. 79 patients in the laparoscopy group and 147 in the laparotomy group. Variables analyzed in both groups were patient age, body mass index, duration of follow-up, FIGO 2009 surgical stage, tumor grade, histopathologic type, number of lymph nodes yielded, operating time, postoperative hospital admission, perioperative and postoperative complications, conversion to laparotomy, recurrence, and survival. Statistical analysis was performed using SPSS version 20.0. The Student t test was used to compare the mean values of continuous variables, and the X2 test was used to compare categorical variables. Results: There were no significant differences in age, weight, body mass index, parity, previous abdominal surgery, number of lymph nodes yielded and menopausal status between the laparoscopy and the laparotomy groups. There were no statistically significant differences in the numbers of nodes and node metastases obtained in the laparoscopy and the laparotomy groups. The operating time was shorter in the laparotomy group. Intraoperative and postoperative complications were significant less frequent in laparoscopy group (13.9% vs. 32.5%; P = 0.003). Women had a similar 5 years estimated recurrence-free survival (98% in laparoscopy vs. 94% laparotomy group) and similar 5 years overall survival rates (100% in laparoscopy vs. 95% laparotomy group). Conclusion: Laparoscopy is safe, and has almost equal efficiency than laparotomy approach in treatment of women with early stage endometrial cancer.