当院における早期子宮体癌に対する低侵襲手術の有効性，安全性についての後方視的検討

抄録

[Objective] We aimed to assess the safety and reliability of minimally invasive surgery (MIS) in the treatment of early-stage endometrial cancer.

[Method] This single-institute retrospective study compared clinical variables and disease-free survival (DFS) rates between an MIS group (38 cases) and a laparotomy group (71 cases) consisting of patients who were preoperatively diagnosed with clinical stage 1A, grade 1/2, endometrioid cancer and subsequently operated in our hospital between 2011 and 2019. The basic surgical procedures used were total hysterectomy, bilateral adnexectomy, and pelvic lymph node dissection.

[Results] The MIS group had a significantly longer operation time of 293 minutes versus the 224 minutes taken in the laparotomy group (median, p<0.01). Moreover, the MIS group had a significantly lower bleeding volume of 45 g compared with the laparotomy group, which was 303 g (median, p<0.01). The postoperative hospital stays were 8 and 12 days in the MIS and laparotomy groups, respectively (p<0.01). There were no significant differences in complications. There was no difference in terms of the DFS rates, which were 97% in both groups. Cox regression analyses showed that ovarian metastasis and high-grade histology were worse prognostic factors for DFS (p<0.001 and p=0.004, respectively).

[Conclusion] MIS was found to be a safe and reliable method for the treatment of early-stage endometrial cancer.