Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial

Obermair, Andreas, Janda, Monika, Baker, Jannah, Kondalsamy-Chennakesavan, Srinivas, Brand, Alison, Hogg, Russell, Jobling, Thomas W., Land, Russell, Manolitsas, Tom, Nascimento, Marcelo, Neesham, Deborah, Nicklin, James L., Oehler, Martin K., Otton, Geoff, Perrin, Lewis, Salfinger, Stuart, Hammond, Ian, Leung, Yee, Sykes, Peter, Ngan, Hextan, Garrett, Andrea, Laney, Michael, Ng, Tong Yow, Tam, Karfai, Chan, Karen, Wrede, David H., Pather, Selvan, Simcock, Bryony, Farrell, Rhonda, Robertson, Gregory, Walker, Graeme, McCartney, Anthony and Gebski, Vak (2012) Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial. European Journal of Cancer, 48 8: 1147-1153.

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Author Obermair, Andreas
Janda, Monika
Baker, Jannah
Kondalsamy-Chennakesavan, Srinivas
Brand, Alison
Hogg, Russell
Jobling, Thomas W.
Land, Russell
Manolitsas, Tom
Nascimento, Marcelo
Neesham, Deborah
Nicklin, James L.
Oehler, Martin K.
Otton, Geoff
Perrin, Lewis
Salfinger, Stuart
Hammond, Ian
Leung, Yee
Sykes, Peter
Ngan, Hextan
Garrett, Andrea
Laney, Michael
Ng, Tong Yow
Tam, Karfai
Chan, Karen
Wrede, David H.
Pather, Selvan
Simcock, Bryony
Farrell, Rhonda
Robertson, Gregory
Walker, Graeme
McCartney, Anthony
Gebski, Vak
Title Improved surgical safety after laparoscopic compared to open surgery for apparent early stage endometrial cancer: Results from a randomised controlled trial
Journal name European Journal of Cancer  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-05
Sub-type Article
DOI 10.1016/j.ejca.2012.02.055
Volume number 48
Issue number 8
ISSN 0959-8049
1879-0852
Start page 1147
End page 1153
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Pergamon
Collection year 2013
Language eng
Formatted abstract Aim

To compare Total Laparoscopic Hysterectomy (TLH) and Total Abdominal Hysterectomy (TAH) with regard to surgical safety.

Methods

Between October 2005 and June 2010, 760 patients with apparent early stage endometrial cancer were enroled in a multicentre, randomised clinical trial (LACE) comparing outcomes following TLH or TAH. The main study end points for this analysis were surgical adverse events (AE), hospital length of stay, conversion from laparoscopy to laparotomy, including 753 patients who completed at least 6 weeks of follow-up. Postoperative AEs were graded according to Common Toxicity Criteria (V3), and those immediately life-threatening, requiring inpatient hospitalisation or prolonged hospitalisation, or resulting in persistent or significant disability/incapacity were regarded as serious AEs.

Results

The incidence of intra-operative AEs was comparable in either group. The incidence of post-operative AE CTC grade 3+ (18.6% in TAH, 12.9% in TLH, p 0.03) and serious AE (14.3% in TAH, 8.2% in TLH, p 0.007) was significantly higher in the TAH group compared to the TLH group. Mean operating time was 132 and 107 min, and median length of hospital stay was 2 and 5 days in the TLH and TAH group, respectively (p < 0.0001). The decline of haemoglobin from baseline to day 1 postoperatively was 2 g/L less in the TLH group (p 0.006).

Conclusions

Compared to TAH, TLH is associated with a significantly decreased risk of major surgical AEs. A laparoscopic surgical approach to early stage endometrial cancer is safe.
Keyword Endometrial cancer
Safety
Surgery
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Medicine Publications
 
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