EP103/#355 Comparison of minimally invasive versus open surgery in treatment of endometrial cancer with high risk of recurrence – retrospective cohort study in Korea and Taiwan. (4th December 2022)

• Record Type: Journal Article
• Authors: Chang, Chi-Son; Lai, Yen-Ling; Choi, Chel Hun; Kim, Tae-Joong; Lee, Jeong-Won; Kim, Byoung-Gie; Chen, Yu-Li; Lee, Yoo-Young
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A90
• Page End: A90
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.194
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: The aim of this study was to compare oncologic outcomes between minimally invasive surgery (MIS) and open surgery in the treatment of endometrial cancer with high risk of recurrence. Methods: This retrospective study included patients with endometrial cancer with high risk factor who underwent primary surgery in two tertiary centers in Korea and Taiwan. Stage III-IVA endometrial cancer with grade 1–2 endometrioid type, stage I-IVA endometrial cancer with grade 3 endometrioid type or non-endometrioid type were considered as factors of high risk of recurrence. We conducted 1:1 propensity score matching between MIS and open surgery group to adjust the baseline characteristics. Oncologic outcomes were compared according to surgical approach. Results: A total of 284 patients were included after propensity score matching. Among them, 32 (11.3%) cases were patients with low grade endometrioid carcinoma with advanced stage, 109 (38.4%) patients were grade 3 endometrioid carcinoma, and 143 (50.3%) were patients with non-endometrioid carcinoma. Compared to patients who underwent open surgery, MIS did not show difference in disease-free survival (HR 1.09, 95% CI 0.67–1.77, P=0.717) and overall survival (HR 0.67, 95% CI 0.36–1.24, P=0.198). In multivariate analysis, non-endometrioid histology, tumor size, tumor in cytology, depth of invasion, and lympho-vascular space invasion were risk factors for recurrence. There was no association between surgical approach in either recurrence or mortality in subgroup analysis according to stage and histologic type. Conclusions: Minimally invasive surgery did not compromise survival outcomes for endometrial cancer with high risk of recurrence when compared to open surgery.