腹腔鏡下子宮体癌根治手術後の再発に関する検討

抄録

Objective: In 2014, laparoscopic surgery for early-stage endometrial cancer was covered by insurance, and the number of cases has increased at the affiliated institutions, with recurrent cases also being experienced. In this study, we examined cases of recurrence after laparoscopic endometrial cancer surgery.

Methods: Patient background, surgical outcomes, and prognosis were retrospectively reviewed for patients who underwent laparoscopic endometrial cancer surgery at affiliated institutions between May 2014 and December 2022. In addition, time to recurrence, site of recurrence, and tumor size of excised specimens were also examined.

Results: Four hundred patients were included in the study, with a median age of 54 years (29-85) and a median observation period of 47 months (12-119). The risk categories of postoperative recurrence were 312 (78.0%) in the low-risk group, 65 (16.3%) in the intermediate-risk group, and 23 (5.8%) in the high-risk group. There were 15 (3.3%) recurrences, with postoperative recurrence risk classified as 9 in the low-risk group, 5 in the intermediate-risk group, and 1 in the high-risk group. The median time to recurrence was 29 months (17-37) in the intermediate and high-risk groups and 40 months (18-71) in the low-risk group (p=0.08). In the low-risk group, there were cases of recurrence more than five years after surgery, and peritoneal dissemination recurrence. Sealing of the fallopian tubes and in-bag collection were performed in all recurrent cases, but uterine manipulators were used.

Conclusion: Although no characteristic recurrence patterns were observed in laparoscopic surgery for endometrial cancer, long-term follow-up was considered necessary in the low-risk.