Long-term survival outcomes of laparoscopic staging surgery in treating endometrial cancer: 20 years of follow-up.

OBJECTIVE: To assess the long-term outcomes of laparoscopic staging surgery (LSS) in treating patients with endometrial carcinoma.

MATERIALS AND METHODS: Patients with endometrial cancer who underwent LSS between June 1995 and June 2014 were prospectively registered. Perioperative data, complications, disease recurrence, and long-term survival were measured.

RESULTS: The study included 287 consecutive patients [mean age (± standard deviation), 53±10.4 years; mean body mass index, 27.3±6.7 kg/m(2)] with a median follow-up ranging from 1 to 216 months. No laparotomy conversion was recorded for any patient. The mean operative time was 207±63.5 minutes, and the mean blood loss was 183±166.7 mL. The mean numbers of pelvic nodes and para-aortic nodes removed were 18±4.8 and 8±5, respectively. More than 80% of the patients had an International Federation of Gynecology and Obstetrics (FIGO) Stage 1 disease. The overall complication rate was 3.1%, including two patients of bladder injuries and one with bowel injury intraoperatively, and postoperatively one patient with pelvic abscess, three with urinary tract infection, one with voiding difficulty, and one with bowel perforation. The overall survival rates were 94% in 5 years and 92.7% in 20 years. No port-site metastasis was recorded in this study.

CONCLUSIONS: Patients with endometrial carcinoma treated by LSS had compatible or even better long-term survival outcomes and less complication in comparison with the published data, in addition to the benefits of its minimally invasive characteristics. LSS should be the treatment of choice for endometrial cancer.