Ca survival similar for laparoscopy, laparotomy.(Gynecology)

NEW YORK -- Survival rates for early-stage endometrial carcinoma are similar between women treated laparoscopically and those who undergo laparotomy, Dr. Farr Nezhat reported at an international congress of the Society of Laparoendoscopic Surgeons.

Accumulating evidence suggests that the laparoscopic approach to performing hysterectomy, bilateral salpingo-oophorectomy (BSO), and staging can provide beneficial results with decreased morbidity, compared with standard laparotomy. However, comparable survival outcomes must be demonstrated before laparoscopy can be accepted as the standard of care, noted Dr. Nezhat, director of Gynecologic Minimally Invasive Surgery and Fellowship at the Mount Sinai Medical Center, New York.

Among 194 women with clinical stage I or II endometrial cancer seen at Mount Sinai Hospital between January 1993 and June 2003, 127 had been treated via laparotomy, while 67 were treated with laparoscopic surgery. All underwent inspection, pelvic washings, hysterectomy, and BSO, while some also received lymphadenectomy and omentectomy, based on the results of inspection and biopsy. Some patients also underwent adjuvant radiation, chemotherapy, or vaginal cuff brachytherapy, depending on disease grade, stage, and histology.

The two groups of women were similar in parity, comorbidity, and the proportion with advanced surgical stage cancer (13% for laparoscopy and 20% for laparotomy). However, the laparoscopy group was significantly younger (59 years ...