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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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 - Jan 2022


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


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