Minimally invasive approach in endometrial cancer with lower uterine segment involvement in stage ≥ II: A retrospective study

Tamar Perri, Gabriel Levin, Limor Helpman, Ram Eitan, Zvi Vaknin, Ofer Lavie, Alon Ben Arie, Amnon Amit, Tally Levy, Ahmet Namazov, Inbar Ben Shachar, Ilan Atlas, Ilan Bruchim, Liron Kogan, Ofer Gemer

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    1 Scopus citations


    Objective: To compare oncological outcomes in women with lower uterine segment involvement (LUSI) in endometrial carcinoma (EC) stage ≥ II - staged by a minimally invasive surgery (MIS) versus laparotomy. Study design: A retrospective multi-center cohort study. Univariate analysis, Kaplan-Meier survival and Cox proportional hazard analysis were performed to compare between women staged by MIS and those staged by laparotomy. Results: Over a median follow-up period of 3 years (interquartile range, 1.5–6 years) 212 women were included, 68 (32.1%) were surgically staged by MIS. Stages of disease did not vary between MIS and laparotomy and were 32.1%, 51.9%, and 16.0%, in stages II, III and IV – respectively. Adjuvant radiation and chemotherapy rate did not differ between groups. Overall recurrence rate was comparable (p = 0.084). Locoregional recurrence rate was higher in the MIS group odds ratio 2.17, 95% confidence interval 1.19–4.20). Overall and progression free survival were similar in both groups (log rank test p = 0.08 and p = 0.912 respectively). In Cox regression model adjusting for age, comorbidities, tumor grade, stage and adjuvant therapy, route of surgery (MIS vs. laparotomy) was not associated with overall survival (p = 0.169). Conclusions: In women with advanced EC and LUSI, although MIS is associated with locoregional recurrences, survival is comparable to laparotomy.

    Original languageEnglish
    Pages (from-to)43-47
    Number of pages5
    JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
    StatePublished - 1 Jan 2022


    • Endometrial cancer
    • Lower uterine segment
    • Minimally invasive
    • Prognosis
    • Recurrence

    ASJC Scopus subject areas

    • Obstetrics and Gynecology
    • Reproductive Medicine


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