Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy for endometrial cancer: morbidity and survival

Am J Obstet Gynecol. 1999 Aug;181(2):376-81. doi: 10.1016/s0002-9378(99)70565-x.

Abstract

Objectives: Our goal was to evaluate the morbidity, recurrence, and survival of patients with clinical stage I endometrial cancer treated by laparoscopic lymphadenectomy with vaginal or laparoscopic hysterectomy and bilateral salpingo-oophorectomy.

Study design: This article is a retrospective review of records for 56 patients. The mean follow-up among those alive at last contact was 2.4 years (range, 32 days-5.2 years). Staging according to the International Federation of Gynecology and Obstetrics (1988) was as follows: I, 45 (80.4%); II, 3 (5.4%); III, 6 (10.7%); and IV, 2 (3.6%).

Results: Intraoperative complications occurred in 4 patients (7.1%). Transformation to laparotomy was necessary in 7 patients. Postoperative complications were observed in 9 patients (16.1%). Pelvic irradiation was administered postoperatively to 11 patients (19.6%). Among the 45 patients with surgical stage I disease, the 3-year recurrence rate was 2.5% and the 3-year cause-specific survival was 96.0%.

Conclusions: Laparoscopic lymphadenectomy and vaginal or laparoscopic hysterectomy with bilateral salpingo-oophorectomy provided 3-year survival and recurrence rates similar to those of the traditional abdominal approach.

MeSH terms

  • Adult
  • Aged
  • Endometrial Neoplasms / mortality*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / surgery
  • Fallopian Tubes / surgery*
  • Female
  • Humans
  • Hysterectomy / methods*
  • Hysterectomy, Vaginal
  • Laparoscopy*
  • Lymph Node Excision / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Ovariectomy / methods*
  • Postoperative Care
  • Postoperative Complications
  • Radiotherapy
  • Retrospective Studies
  • Survival Rate