Long-term outcome of minimally invasive staging surgery for clinical stage I endometrial cancer - A single institute experience in Taiwan

Q: What comparison does the study make for clinical stage I endometrial cancer?

It compares outcomes between minimally invasive surgery (MIS) and laparotomy staging surgery using real-world data with long-term follow-up.

Q: What endpoints were evaluated to compare MIS and laparotomy?

The study evaluated safety, morbidity, progression-free survival (PFS), and overall survival (OS), along with clinical and pathologic factors.

Q: Did survival outcomes differ after adjusting presurgery risk factors?

After adjusting for presurgery risk factors, PFS and OS showed no significant difference between MIS and laparotomy groups.

Sep 29, 2026

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Endometrial cancer remains the most common gynecological cancer in developed countries, and minimally invasive surgery (MIS) is increasingly adopted for clinical stage I disease. This single-institute Taiwan study used real-world data with long-term follow-up to compare MIS versus laparotomy staging, evaluating safety, morbidity, progression-free survival (PFS), and overall survival (OS) across comprehensive surgical staging cohorts. Results assessed survival via Kaplan-Meier and Cox modeling.

LanguageEnglish

CategoryResearch & Report

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Pages9

Reading Time23 min

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Abstract

Background

Methods

Results

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Introduction

J Chin MedAssoc Original article Long-term outcome of minimally invasive staging surgery for clinical stage I endometrial cancer: A single institute experience in Taiwan Ting-Fang Lua, Chien-Hsing Lua,b,c, Lou Suna, Chi-Ku Liua, Yu-Hsiang Shiha, Sheau-Feng Hwanga, Shih-Tien Hsua,d,e,* aDepartment of Obstetrics and Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; bSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cInstitute of Biomedical Sciences, Ph.D. Program in Translational Medicine, and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC; dCenter for General Education, Ling Tung University, Taichung, Taiwan, ROC; eSchool of Medicine, China Medical University, Taichung, Taiwan, ROC Abstract Background: Endometrial cancer is the most common gynecological cancer in developed countries. With recent advances in equipment and knowledge, minimally invasive surgery (MIS) is widely accepted for the treatment of endometrial cancer. This study had the largest number of cases to date in Taiwan, comparing outcomes between MIS and laparotomy staging surgery using realworld data with long-term follow-up. Methods: We retrospectively reviewed patients with clinical stage 1 endometrial cancer from 2009 to 2020 in our institute. All patients underwent comprehensive surgical staging procedures by MIS or laparotomy. The safety, morbidity, progression-free survival (PFS), and overall survival (OS) rates of the two groups were compared. Clinical and pathologic factors were compared with Chi-square and Fisher Exact test. PFS and OS were estimated by the Kaplan-Meier method. Differences between survival curves were analyzed using the log-rank test. A p value of <0 .05 was considered statistically significant. Using Cox proportional hazards models, all factors found to be significantly associated with risk of recurrence on univariate analyses were then assessed together through multivariable models, resulting in a final oncologic outcome between MIS and laparotomy. Results: A total of 665 cases (412 cases in MIS group and 253 cases in laparotomy group) were enrolled for data analysis. Median operation time was shorter in MIS group (244 and 265 minutes, p < 0 .001) . Median blood loss was also less (75 and 430 mL, p < 0.001) . Median postoperative hospitalization duration was longer in the laparotomy group (2 and 7 days, p = 0 .001) . After adjusting presurgery risk factors, the PFS and OS were no significant difference in MIS and laparotomy groups. Conclusion: Using real-world data with long-term follow-up, we could confirm excellent PFS and OS in selective patients with clinical stage 1 endometrial carcinoma who received MIS, and the surgical time, hospital day, and blood loss were also less. Keywords: Endometrial cancer; Laparoscopy; Minimally invasive surgery 1. INTRODUCTION Endometrial cancer is the fifth most common cancer among women worldwide (4 . 8% of cancers in women) .1,2 In United States, the incidence rates of endometrial cancer increased 2.5% annually, with a 10% increase from 2006 to 2012.3 The Bureau of Health Promotion (Department of Health, Taipei, Taiwan) reported 1165 new cases of endometrial cancer in 2007 and * Address correspondence. Dr. Shih-Tien Hsu, Department of Obstetrics, Gynecology and Women’s Health, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Section 4, Taichung 407, Taiwan, ROC. E-mail address: sthsu@ [vghtc.gov.tw](vghtc.gov.tw) (S.-T. Hsu). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 79-87. Received February 17, 2023; accepted July 30, 2023. doi: 10. 1097/JCMA.0000000000001006 Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND

FAQs

What comparison does the study make for clinical stage I endometrial cancer?

It compares outcomes between minimally invasive surgery (MIS) and laparotomy staging surgery using real-world data with long-term follow-up.

What endpoints were evaluated to compare MIS and laparotomy?

The study evaluated safety, morbidity, progression-free survival (PFS), and overall survival (OS), along with clinical and pathologic factors.

Did survival outcomes differ after adjusting presurgery risk factors?

After adjusting for presurgery risk factors, PFS and OS showed no significant difference between MIS and laparotomy groups.

Sep 29, 2026

Upload by Aria