GYOEDU

LAP2

Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: gynecologic oncology group study LAP2

Date of Publication:

October 5, 2009

Pubmed Link:

https://pubmed.ncbi.nlm.nih.gov/19805679/

Hypothesis:

Laparoscopy is non-inferior to open (laparotomy) hysterectomy for women with early stage endometrial cancer

Control Arm(s):

total abdominal (extrafascial) hysterectomyBSO, cytology, pelvic and para-aortic lymphadenectomy

Experimental Arm(s):

total laparoscopic hysterectomyBSO, cytology, pelvic and para-aortic lymphadenectomy

Primary End Point:

Recurrence-free survival

Inclusion Criteria:

clinical stage I - IIA (FIGO 1988)

Exclusion Criteria:

renal or hepatic dysfunction

Results:

TAH (n=909) vs TLH (n=1682):OP time: 130 vs 204 min (SS)intraop complications: 8% vs 10% (NS)grade 2+ postop complications: 21% vs 14% (SS)2+ day hospital stay: 94% vs 52% (SS)Rate of LN non-removal: 4% vs 8% (SS)Advanced stage diagnosis: 17% vs 17% (NS)26% conversion rate (lap to open): most common reason poor visibility

Conclusions:

Laparoscopic surgical staging for uterine cancer is feasible and safe in terms of short-term outcomes, resulting in fewer complications.

Reviewer:

Olga T Filippova