American Journal of Obstetrics and Gynecology
Original ResearchGynecologySurgical outcomes among elderly women with endometrial cancer treated by laparoscopic hysterectomy: a NRG/Gynecologic Oncology Group study
Section snippets
Materials and Methods
This was an analysis of patients who were enrolled in LAP-2, a GOG clinical trial. The details of inclusion and exclusion criteria were reported in the original manuscript.10 Briefly, the study was designed to compare LAVH with LAP for the purpose of complete comprehensive surgical staging of uterine cancer.
The primary outcome of the study was recurrence-free survival. Other endpoints included perioperative adverse events, LAVH conversion to LAP, length of hospital stay after surgery, operative
LAP2 population demographics, pathology, and outcomes
From the total LAP2 population, 762 patients are 60-69 years old, and 715 patients are ≥70 years old. Demographic data, including BMI, performance status, disease characteristics, postoperative therapy, recurrence, and survival by decade of age, are shown in Table 1. As age increases, BMI decreases (P < .001) and performance status worsens (P < .001), and when looking at disease characteristics, there are increasing rates of serous histology (P < .001), higher-stage disease (P < .001), and more
Comment
This analysis shows a clear difference in morbidity associated with surgical approach in older endometrial cancer patients. Results from this analysis show that while there are overall low rates of intraoperative and postoperative complications during complete surgical staging, regardless of surgical approach, patients undergoing LAP experience more postoperative complications with increasing age.
An increased benefit to laparoscopic staging is seen beginning at age 60 years old, with increased
Acknowledgments
The following Gynecologic Oncology Group member institutions participated in the primary treatment studies: Abington Memorial Hospital, Walter Reed Army Medical Center, University of Minnesota Medical School, University of Mississippi Medical Center, University of Pennsylvania Cancer Center, University of California at San Diego, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, University of California
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Cited by (42)
Gastrointestinal outcomes among older women with endometrial cancer
2023, Gynecologic OncologyAssessment of the feasibility of same-day discharge following minimally invasive hysterectomy in the elderly population
2023, Gynecologic Oncology ReportsRole of minimally invasive surgery in gynecologic malignancies
2023, DiSaia and Creasman Clinical Gynecologic OncologyRacial and ethnic disparities in readmission risk following the surgical management of endometrial cancer
2022, Gynecologic OncologyCitation Excerpt :Surgical management with hysterectomy is the cornerstone of EC treatment. The advent of laparoscopy ushered in a new era of minimally invasive surgery for EC, leading to decreased intraoperative and postoperative complications and lower rates of readmission [9–13]. Moreover, oncologic outcomes for women undergoing minimally invasive hysterectomy (MIH) for EC are similar to those undergoing laparotomy [14–16].
This study was supported by National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (grant CA 27469), the Gynecologic Oncology Group Statistical and Data Center (grant CA 37517), the NRG Oncology SDMC grant U10 CA180822, and the NRG Oncology Operations grant U10CA 180868.
The authors report no conflict of interest.
Current address for Dr Bishop: Department of Obstetrics and Gynecology, Division of Gynecology Oncology, Medical College of Wisconsin, Milwaukee, WI.
Cite this article as: Bishop EA, Java JJ, Moore KN, et al. Surgical outcomes among elderly women with endometrial cancer treated by laparoscopic hysterectomy: a NRG/Gynecologic Oncology Group study. Am J Obstet Gynecol 2018;218:109.e1-11.