Laparoscopy or laparotomy for early endometrial cancer?
2010; Elsevier BV; Volume: 11; Issue: 11 Linguagem: Inglês
10.1016/s1470-2045(10)70195-9
ISSN1474-5488
Autores Tópico(s)Endometriosis Research and Treatment
ResumoI read with interest Monika Janda and colleagues' 1 Janda M Gebski V Brand A et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010; 11: 772-780 Summary Full Text Full Text PDF PubMed Scopus (240) Google Scholar article about quality of life (QoL) after total laparoscopic hysterectomy (TLH) versus total abdominal hysterectomy (TAH) for stage I endometrial cancer. After a decade of retrospective, poorly powered studies, it is refreshing that we now have three prospective studies from which clinicians can draw inferences to guide them in their own clinical practice. 1 Janda M Gebski V Brand A et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): a randomised trial. Lancet Oncol. 2010; 11: 772-780 Summary Full Text Full Text PDF PubMed Scopus (240) Google Scholar , 2 Mourits MJ Bijen CB Art HJ et al. Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomised trial. Lancet Oncol. 2010; 11: 763-771 Summary Full Text Full Text PDF PubMed Scopus (233) Google Scholar , 3 Kornblith AB Huang HQ Walker JL Spirtos NM Rotmensch J Cella D Quality of life of patients with endometrial cancer undergoing laparoscopic international federation of gynecology and obstetrics staging compared with laparotomy: a Gynecologic Oncology Group study. J Clin Oncol. 2009; 27: 5337-5342 Crossref PubMed Scopus (233) Google Scholar However, there are no convincing data to show a long-term, overall benefit of laparoscopy compared with laparotomy for the surgical management of endometrial cancer. Laparoscopy or laparotomy for early endometrial cancer? – Authors' replyOf three randomised trials1–3 that have recently reported quality of life (QoL) and surgical outcomes, two have shown that laparoscopy is better than laparotomy, and the third reported comparable outcomes for both techniques. Advantages of total laparoscopic hysterectomy (TLH) include improved and faster recovery from surgery—as indicated by the QoL data of patients—and an approximately 50% reduction in postoperative adverse events. The three trials originate from different continents (ie, USA, Europe, and Australia) and this should be considered when interpreting their results. Full-Text PDF
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