Objective: To clarify the feasibility and safety of laparoscopic surgery for endometrial cancer.
Materials and Methods: Ninety-one patients with endometrial cancer who had undergone laparoscopic surgery in our institution between August 2012 and June 2016 were retrospectively studied. Data regarding surgical procedures, blood loss, surgical time, number of harvested lymph nodes, complications, and prognosis of the patients were obtained from medical records and analyzed.
Results: All patients had a pathologically confirmed endometrial cancer before the surgery, and their median age was 56 years. Of these, 57 patients underwent total laparoscopic hysterectomy (TLH) and bilateral salpingo-oophorectomy (BSO), and 34 patients underwent lymph node dissection in addition to TLH and BSO. After the surgery, histological examination showed that 78% of cases were high-grade endometrioid adenocarcinoma and 69.2% were the International Federation of Gynecology and Obstetrics (FIGO) stage IA. No case needed conversion to laparotomy or blood transfusion. Based on the Common Terminology Criteria for Adverse Events, complications with grade 3 or more were seen in 6.6% of patients intra-operatively, including venous and nerve injury, and seen in 6.6% of patients post-operatively, including ileus and pelvic abscess. During the follow up period (median of 23 months), 5 patients experienced recurrence, and no patient died of cancer. The rate of complications, number of harvested lymph nodes, and rate of good prognosis of our patients were not lower than that reported by previous studies.
Conclusion: The safety of laparoscopic surgery for endometrial cancer performed in our institution was found to similar to that performed in other countries. It should be more widely used worldwide and in Japan for stage IA patients and might be considered for patients with stage IB or higher endometrial cancer.
