Could the Long-Term Oncological Safety of Laparoscopic Surgery in Low-Risk Endometrial Cancer also Be Valid for the High-Intermediate- and High-Risk Patients? A Multi-Center Turkish Gynecologic Oncology Group Study Conducted with 2745 Endometrial Cancer Cases. (TRSGO-End-001)
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Tarih
2021Yazar
Vardar, Mehmet Ali
Guzel, Ahmet Baris
Taskin, Salih
Gungor, Mete
Ozgul, Nejat
Salman, Coskun
Kucukgoz-Gulec, Umran
Khatib, Ghanim
Taskiran, Cagatay
Duender, Ilkkan
Ortac, Firat
Yuce, Kunter
Terek, Cosan
Simsek, Tayup
Ozsaran, Aydin
Onan, Anil
Coban, Gonca
Topuz, Samet
Demirkiran, Fuat
Takmaz, Ozguc
Kose, M. Faruk
Gocmen, Ahmet
Seydaoglu, Gulsah
Gumurdulu, Derya
Ayhan, Ali
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This study was conducted to compare the long-term oncological outcomes of laparotomy and laparoscopic surgeries in endometrial cancer under the light of the 2016 ESMO-ESGO-ESTRO risk classification system, with particular focus on the high-intermediate- and high-risk categories. Using multicentric databases between January 2005 and January 2016, disease-free and overall survivals of 2745 endometrial cancer cases were compared according to the surgery route (laparotomy vs. laparoscopy). The high-intermediate- and high-risk patients were defined with respect to the 2016 ESMO-ESGO-ESTRO risk classification system, and they were analyzed with respect to differences in survival rates. Of the 2745 patients, 1743 (63.5%) were operated by laparotomy, and the remaining were operated with laparoscopy. The total numbers of high-intermediate- and high-risk endometrial cancer cases were 734 (45%) patients in the laparotomy group and 307 (30.7%) patients in the laparoscopy group. Disease-free and overall survivals were not statistically different when compared between laparoscopy and laparotomy groups in terms of low-, intermediate-, high-intermediate- and high-risk endometrial cancer. In conclusion, regardless of the endometrial cancer risk category, long-term oncological outcomes of the laparoscopic approach were found to be comparable to those treated with laparotomy. Our results are encouraging to consider laparoscopic surgery for high-intermediate- and high-risk endometrial cancer cases.