Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups

Objective To compare the recurrence rate and prognosis between minimally invasive surgical (MIS) approach and open surgical approach of endometrial carcinoma (EC) patients with different prognostic risk groups. Methods A retrospective analysis of all cases undergoing EC surgery between January 2011...

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Main Authors: Bin Liu, Jie Lin, Wenju Liu, Weiting Chen, Wanzhen Lin, Wei Chen
Format: Article
Language:English
Published: Taylor & Francis Group 2023-01-01
Series:Journal of Investigative Surgery
Subjects:
Online Access:http://dx.doi.org/10.1080/08941939.2022.2126565
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author Bin Liu
Jie Lin
Wenju Liu
Weiting Chen
Wanzhen Lin
Wei Chen
author_facet Bin Liu
Jie Lin
Wenju Liu
Weiting Chen
Wanzhen Lin
Wei Chen
author_sort Bin Liu
collection DOAJ
description Objective To compare the recurrence rate and prognosis between minimally invasive surgical (MIS) approach and open surgical approach of endometrial carcinoma (EC) patients with different prognostic risk groups. Methods A retrospective analysis of all cases undergoing EC surgery between January 2011 and March 2018 was performed. The patients were grouped according to the management guidelines of EC patients jointly formulated by the ESGO/ESTRO/ESP 2020. Different surgical approaches were compared with regard to tumor characteristics, recurrence rate, disease-free survival (DFS), and overall survival (OS). Results A total of 665 patients met the inclusion criteria of which 196 patients underwent MIS (29.5%), and 469 patients underwent open surgery (70.5%). In the MIS group, there was a significant higher rate of recurrence (17.3% vs 6.6%, P = 0.000) compared to the open surgery group. The recurrence rate of MIS was 7.7% (P = 0.000) in the medium-high risk group and 8.2% (P = 0.014) in the high-risk group. Multivariate logistic regression analysis showed that the independent factors influencing recurrence included prognostic risk grouping, surgical approach and lymph vascular space invasion (LVSI) positivity (P < 0.05). K-M survival analysis revealed that in the intermediate and high-risk group of EC, MIS patients had a significantly lower DFS than those undergoing open surgery (P < 0.05), but no significant difference was found in OS. Conclusions For patients with EC at moderate and high prognostic risk, MIS is associated with poorer DFS compared to open surgery, but OS was similar across prognostic risk groups. The application of MIS in patients with moderate and high-risk EC needs further research and analysis.
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spelling doaj.art-6dce5eae419642d99140de4cb8c153b92023-09-15T10:21:30ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532023-01-0136111010.1080/08941939.2022.21265652126565Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk GroupsBin Liu0Jie Lin1Wenju Liu2Weiting Chen3Wanzhen Lin4Wei Chen5Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Gastrointestinal Surgical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalObjective To compare the recurrence rate and prognosis between minimally invasive surgical (MIS) approach and open surgical approach of endometrial carcinoma (EC) patients with different prognostic risk groups. Methods A retrospective analysis of all cases undergoing EC surgery between January 2011 and March 2018 was performed. The patients were grouped according to the management guidelines of EC patients jointly formulated by the ESGO/ESTRO/ESP 2020. Different surgical approaches were compared with regard to tumor characteristics, recurrence rate, disease-free survival (DFS), and overall survival (OS). Results A total of 665 patients met the inclusion criteria of which 196 patients underwent MIS (29.5%), and 469 patients underwent open surgery (70.5%). In the MIS group, there was a significant higher rate of recurrence (17.3% vs 6.6%, P = 0.000) compared to the open surgery group. The recurrence rate of MIS was 7.7% (P = 0.000) in the medium-high risk group and 8.2% (P = 0.014) in the high-risk group. Multivariate logistic regression analysis showed that the independent factors influencing recurrence included prognostic risk grouping, surgical approach and lymph vascular space invasion (LVSI) positivity (P < 0.05). K-M survival analysis revealed that in the intermediate and high-risk group of EC, MIS patients had a significantly lower DFS than those undergoing open surgery (P < 0.05), but no significant difference was found in OS. Conclusions For patients with EC at moderate and high prognostic risk, MIS is associated with poorer DFS compared to open surgery, but OS was similar across prognostic risk groups. The application of MIS in patients with moderate and high-risk EC needs further research and analysis.http://dx.doi.org/10.1080/08941939.2022.2126565endometrial carcinomaminimally invasive surgeryprognosisopen surgery
spellingShingle Bin Liu
Jie Lin
Wenju Liu
Weiting Chen
Wanzhen Lin
Wei Chen
Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
Journal of Investigative Surgery
endometrial carcinoma
minimally invasive surgery
prognosis
open surgery
title Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
title_full Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
title_fullStr Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
title_full_unstemmed Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
title_short Recurrence and Survival Rates of Patients Who Undergo Minimally Invasive Surgery for Endometrial Carcinoma with Different Prognostic Risk Groups
title_sort recurrence and survival rates of patients who undergo minimally invasive surgery for endometrial carcinoma with different prognostic risk groups
topic endometrial carcinoma
minimally invasive surgery
prognosis
open surgery
url http://dx.doi.org/10.1080/08941939.2022.2126565
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