Comparison of minimally invasive surgery with laparotomic approach in the treatment of high risk endometrial cancer: A systematic review

To analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC) in term of operative, peri-operative and oncological outcomes. We conducted a systematic literature search in PubMed between January 1995–Ma...

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Published in	European journal of surgical oncology Vol. 46; no. 5; pp. 782 - 788
Main Authors	Scaletta, G., Dinoi, G., Capozzi, V., Cianci, S., Pelligra, S., Ergasti, R., Fagotti, A., Scambia, G., Fanfani, F.
Format	Journal Article
Language	English
Published	England Elsevier Ltd 01.05.2020
Subjects	Adenocarcinoma, Clear Cell - pathology Adenocarcinoma, Clear Cell - surgery Carcinoma, Endometrioid - pathology Carcinoma, Endometrioid - surgery Carcinosarcoma - pathology Carcinosarcoma - surgery Endometrial cancer Endometrial Neoplasms - pathology Endometrial Neoplasms - surgery Female High-risk endometrial cancer Humans Hysterectomy - methods Laparoscopy Laparotomy Minimally invasive surgery Minimally Invasive Surgical Procedures - methods Neoplasm Grading Neoplasms, Cystic, Mucinous, and Serous - pathology Neoplasms, Cystic, Mucinous, and Serous - surgery Risk High-risk endometrial cancer Minimally invasive surgery Laparoscopy Endometrial cancer
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Abstract	To analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC) in term of operative, peri-operative and oncological outcomes. We conducted a systematic literature search in PubMed between January 1995–March 2019. Titles and abstracts were analyzed by two reviewers. A set of explicit criteria was used for selection of literature: 1) randomized controlled trials (RCT), prospective or retrospective cohort studies, given the rarity of this tumor and the concomitant lack of data in the form of large trials, all reviewed original report publications with an appropriate number of subjects were considered and included; 2) participants of interest being patients who have suffered from high risk EC 3) the outcome measures including overall survival (OS), disease-free survival (DFS) and recurrence, (4) English language, (5) abstract available. Thirty relevant articles were selected for full reading. For final analysis 20 studies were selected. Then, as second step, the full articles were evaluated to determine whether full inclusion criteria were met. In total, 9 papers were identified and included. MIS appears to be safe in the management of high-risk EC patients, showing better perioperative and postoperative outcomes and comparable oncological outcomes than open surgery. Prospective randomized trial would be needed to confirm this data.
AbstractList	To analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC) in term of operative, peri-operative and oncological outcomes. We conducted a systematic literature search in PubMed between January 1995-March 2019. Titles and abstracts were analyzed by two reviewers. A set of explicit criteria was used for selection of literature: 1) randomized controlled trials (RCT), prospective or retrospective cohort studies, given the rarity of this tumor and the concomitant lack of data in the form of large trials, all reviewed original report publications with an appropriate number of subjects were considered and included; 2) participants of interest being patients who have suffered from high risk EC 3) the outcome measures including overall survival (OS), disease-free survival (DFS) and recurrence, (4) English language, (5) abstract available. Thirty relevant articles were selected for full reading. For final analysis 20 studies were selected. Then, as second step, the full articles were evaluated to determine whether full inclusion criteria were met. In total, 9 papers were identified and included. MIS appears to be safe in the management of high-risk EC patients, showing better perioperative and postoperative outcomes and comparable oncological outcomes than open surgery. Prospective randomized trial would be needed to confirm this data. To analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC) in term of operative, peri-operative and oncological outcomes.OBJECTIVETo analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC) in term of operative, peri-operative and oncological outcomes.We conducted a systematic literature search in PubMed between January 1995-March 2019.DATA SOURCESWe conducted a systematic literature search in PubMed between January 1995-March 2019.Titles and abstracts were analyzed by two reviewers. A set of explicit criteria was used for selection of literature: 1) randomized controlled trials (RCT), prospective or retrospective cohort studies, given the rarity of this tumor and the concomitant lack of data in the form of large trials, all reviewed original report publications with an appropriate number of subjects were considered and included; 2) participants of interest being patients who have suffered from high risk EC 3) the outcome measures including overall survival (OS), disease-free survival (DFS) and recurrence, (4) English language, (5) abstract available.METHODS OF STUDY SELECTIONTitles and abstracts were analyzed by two reviewers. A set of explicit criteria was used for selection of literature: 1) randomized controlled trials (RCT), prospective or retrospective cohort studies, given the rarity of this tumor and the concomitant lack of data in the form of large trials, all reviewed original report publications with an appropriate number of subjects were considered and included; 2) participants of interest being patients who have suffered from high risk EC 3) the outcome measures including overall survival (OS), disease-free survival (DFS) and recurrence, (4) English language, (5) abstract available.Thirty relevant articles were selected for full reading. For final analysis 20 studies were selected. Then, as second step, the full articles were evaluated to determine whether full inclusion criteria were met. In total, 9 papers were identified and included.RESULTSThirty relevant articles were selected for full reading. For final analysis 20 studies were selected. Then, as second step, the full articles were evaluated to determine whether full inclusion criteria were met. In total, 9 papers were identified and included.MIS appears to be safe in the management of high-risk EC patients, showing better perioperative and postoperative outcomes and comparable oncological outcomes than open surgery. Prospective randomized trial would be needed to confirm this data.CONCLUSIONMIS appears to be safe in the management of high-risk EC patients, showing better perioperative and postoperative outcomes and comparable oncological outcomes than open surgery. Prospective randomized trial would be needed to confirm this data.
Author	Scaletta, G. Dinoi, G. Pelligra, S. Scambia, G. Fanfani, F. Capozzi, V. Cianci, S. Fagotti, A. Ergasti, R.
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Keywords	High-risk endometrial cancer Minimally invasive surgery Laparoscopy Endometrial cancer
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Snippet	To analyze all published studies comparing minimally invasive surgery (MIS) with laparotomic one in the surgical treatment of high-risk endometrial cancer (EC)...
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SubjectTerms	Adenocarcinoma, Clear Cell - pathology Adenocarcinoma, Clear Cell - surgery Carcinoma, Endometrioid - pathology Carcinoma, Endometrioid - surgery Carcinosarcoma - pathology Carcinosarcoma - surgery Endometrial cancer Endometrial Neoplasms - pathology Endometrial Neoplasms - surgery Female High-risk endometrial cancer Humans Hysterectomy - methods Laparoscopy Laparotomy Minimally invasive surgery Minimally Invasive Surgical Procedures - methods Neoplasm Grading Neoplasms, Cystic, Mucinous, and Serous - pathology Neoplasms, Cystic, Mucinous, and Serous - surgery Risk
Title	Comparison of minimally invasive surgery with laparotomic approach in the treatment of high risk endometrial cancer: A systematic review
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