Less invasive hysterectomy for early-stage endometrial cancer finds clinical support
- Date:
- March 28, 2017
- Source:
- The JAMA Network Journals
- Summary:
- Researchers found similar rates of disease-free survival and no difference in overall survival among women who received a laparoscopic or abdominal total hysterectomy for stage I endometrial cancer, according to a study.
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Researchers found similar rates of disease-free survival and no difference in overall survival among women who received a laparoscopic or abdominal total hysterectomy for stage I endometrial cancer, according to a study published by JAMA.
Endometrial cancer is the most common gynecological cancer in developed countries. Standard treatment involves removal of the uterus, tubes, ovaries and lymph nodes. Laparoscopic hysterectomy is associated with less morbidity and results in better recovery than open operations, but it is not known if the operation results in survival outcomes equivalent to abdominal hysterectomy.
Andreas Obermair, M.D., of the University of Queensland, Herston, Australia, and colleagues randomly assigned 760 women with stage I endometrial cancer to either total abdominal hysterectomy (TAH; n = 353) or total laparoscopic hysterectomy (TLH; n = 407).
Disease-free survival at 4.5 years was 81.6 percent with total laparoscopic hysterectomy vs 81.3 percent with total abdominal hysterectomy (between-group difference, 0.3 percent), meeting the prespecified criteria for equivalence (a margin of seven percent or less). There was no statistically significant between-group difference in recurrence of endometrial cancer (7.9 percent in the TAH group vs 8.1 percent in the TLH group) or in overall survival (6.8 percent in the TAH group vs 7.4 percent in the TLH group).
"These findings support the use of laparoscopic hysterectomy for women with stage I endometrial cancer," the authors write.
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Materials provided by The JAMA Network Journals. Note: Content may be edited for style and length.
Journal Reference:
- Monika Janda, Val Gebski, Lucy C. Davies, Peta Forder, Alison Brand, Russell Hogg, Thomas W. Jobling, Russell Land, Tom Manolitsas, Marcelo Nascimento, Deborah Neesham, James L. Nicklin, Martin K. Oehler, Geoff Otton, Lewis Perrin, Stuart Salfinger, Ian Hammond, Yee Leung, Peter Sykes, Hextan Ngan, Andrea Garrett, Michael Laney, Tong Yow Ng, Karfai Tam, Karen Chan, C. David Wrede, Selvan Pather, Bryony Simcock, Rhonda Farrell, Gregory Robertson, Graeme Walker, Nigel R. Armfield, Nick Graves, Anthony J. McCartney, Andreas Obermair. Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival Among Women With Stage I Endometrial Cancer. JAMA, 2017; 317 (12): 1224 DOI: 10.1001/jama.2017.2068
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