Long term outcome after laparoscopic versus open abdominal hysterectomy in endometrial cancer patients: a 25-year analysis of the Jena University hospital cohort

Introduction Laparoscopic hysterectomy is performed nowadays for patients with low-risk endometrial cancer as a standard surgery approach; however, long-term outcome of the minimally invasive technique related with higher risk disease remains uncertain.

Methods 359 patients with endometrial cancer underwent laparoscopic or abdominal hysterectomy in our center from 1996 till 2010. They were categorized in two groups: low-risk (stage IA without nodes metastasis, G2 or G2 with endometroid carcinoma) and high-risk (stage IB or G3 or with nodes metastasis or serous papillary or clear cell type). Median follow-up was 72 months (minimum=2, maximum=214).

Results In low risk patients, disease-free survival (DFS) rate was 95.6% after laparoscopic (n=158) 92.9% after abdominal hysterectomy (n=43). Overall survival (OS) rate was 96.6% vs. 100%. DFS rate in high risk patients was 75.3% in the laparoscopy group (n=97) and 73.3% in the open surgery group (n=61). OS rate was 85.1% versus 84.2%. Statistical interpretation of our data is challenging because of violated proportional hazards assumption.

Conclusions Based on preliminary data of our cohort, the laparoscopic procedure was not inferior in low risk as well as in high risk patients. However, we are in the process of completing a larger evaluation, adding data of patients treated in the period from 2010 to 2021.

Publication History

Article published online:
11 October 2022