Lap, Abdominal Hysterectomy Equal for Early Endometrial CA

Equivalent disease-free survival at 4.5 years for stage I endometrial cancer with TAH, TLH


TUESDAY, March 28, 2017 (HealthDay News) -- For women with stage I endometrial cancer, total laparoscopic hysterectomy (TLH) is equivalent to total abdominal hysterectomy (TAH) for disease-free survival at 4.5 years, according to a study published in the March 28 issue of the Journal of the American Medical Association.

Monika Janda, Ph.D., from the Queensland University of Technology in Brisbane, Australia, and colleagues randomized 760 women with stage I endometrioid endometrial cancer to TAH (353 women) or TLH (407 women). Patients were followed for a median of 4.5 years; 89 percent of patients completed the trial.

The researchers found that disease-free survival was 81.3 and 81.6 percent in the TAH and TLH groups, respectively, at 4.5 years of follow-up, with a disease-free survival difference of 0.3 percent favoring TLH (95 percent confidence interval, −5.5 to 6.1 percent; P = 0.007), meeting the criteria for equivalence. There was no statistically significant difference between the groups in the recurrence of endometrial cancer (7.9 versus 8.1 percent; risk difference, 0.2 percent; 95 percent confidence interval, −3.7 to 4.0 percent; P = 0.93) or in overall survival (6.8 versus 7.4 percent; risk difference, 0.6 percent; 95 percent confidence interval, −3.0 to 4.2 percent; P = 0.76).

"These findings support the use of laparoscopic hysterectomy for women with stage I endometrial cancer," the authors write.

Several authors disclosed financial ties to the medical device industry.

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