Please wait a minute...
European Journal of Gynaecological Oncology  2019, Vol. 40 Issue (6): 977-981    DOI: 10.12892/ejgo4872.2019
Original Research Previous articles | Next articles
The impact of laparoscopic surgical treatments on oncologic outcome of Stage I uterine leiomyosarcoma
Z. Zheng1, Z.H. Han2, Z.T. Li1, X.H. Wu1, *()
1The Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
2The Department of Gynecologic Oncology, Shaanxi Provincial Tumor Hospital, Xi'an, China
Download:  PDF(869KB)  ( 174 ) Full text   ( 7 )
Export:  BibTeX | EndNote (RIS)      
Abstract  

Background: Morcellation may worsen the outcome of occult uterine leiomyosarcoma (uLMS), while the effect of laparoscopic surgery itself, without morcellation, on the oncological outcomes of patients with early stage uLMS is also currently unknown. Materials and Methods: A retrospective analysis of 75 patients who underwent treatment for Stage I uLMS at Shanghai Cancer Center was performed. Kaplan-Meier and Cox proportional hazards regression models were used for analyses. Results: Fifty-five patients underwent primary open surgery and 20 underwent laparoscopy. Patient age was significantly lower in the laparoscopy (44 ± 9.04 years) compared with the open surgery group (50.85 ± 9.96 years) (p < 0.007). Laparoscopic surgery was associated with shorter overall survival (OS) according to Kaplan-Meier (KM) log-rank test (p = 0.046), and multivariate Cox regression ([ = 0.032, RR = 2.423, 95% confidence interval, 1.081-5.429), but not disease-free survival (DFS) (p = 0.682, Kaplan--Meier log-rank test). In stratification analysis, patients who underwent laparoscopic total hysterectomy/modified radical hysterectomy (without morcellation ) had shorter DFS (p = 0.006) and OS (p = 0.001), compared with the open group. However, laparoscopic myomectomy and sub-total hysterectomy were associated with a similar DFS (p =0.924) and OS (p =0.580) to open total hysterectomy/modified radical hysterectomy. There was no significant difference in DFS (p = 0.941) or OS (p = 0.737) between laparoscopic surgery with and without morcellation. Conclusions: Laparoscopic surgery may be associated with poorer survival than open surgery in patients with early stage uLMS, even in the absence of morcellation.

Key words:  Uterine leiomyosarcoma      Laparoscopy      Recurrence      Survival     
Published:  10 December 2019     
*Corresponding Author(s):  X.H. WU     E-mail:  docwuxh@hotmail.com

Cite this article: 

Z. Zheng, Z.H. Han, Z.T. Li, X.H. Wu. The impact of laparoscopic surgical treatments on oncologic outcome of Stage I uterine leiomyosarcoma. European Journal of Gynaecological Oncology, 2019, 40(6): 977-981.

URL: 

https://ejgo.imrpress.com/EN/10.12892/ejgo4872.2019     OR     https://ejgo.imrpress.com/EN/Y2019/V40/I6/977

[1] Ji Geun Yoo, Hae Nam Lee, Sung Jong Lee, Jin Hwi Kim, Yong Seok Lee, Ahwon Lee, Soo Young Hur, Keun Ho Lee. Germline BRCA2 mutation is associated with greater progression-free survival in korean women with advanced high-grade serous ovarian cancer[J]. European Journal of Gynaecological Oncology, 2020, 41(5): 675-680.
[2] T. Uehara, A. Mitsuhashi, M. Shozu. The impact of pre-existing polycystic ovary syndrome on endometrial cancer recurrence[J]. European Journal of Gynaecological Oncology, 2020, 41(5): 668-674.
[3] Silvia Ortega, José Angel Mínguez, José Manuel Aramendía, Marta Santisteban, Fernando Martinez-Regueira, Pablo Martí-Cruchaga, Juan Luis Alcázar, Matías Jurado. The impact of secondary cytoreductive surgery on survival in first recurrence of platinum sensitive epithelial ovarian cancer[J]. European Journal of Gynaecological Oncology, 2020, 41(4): 523-530.
[4] Jae Hong Sang, Soo-Ho Chung. Is it enough in ovarian cancer staging surgery to laparoscopic surgery? Comparison of surgical methods[J]. European Journal of Gynaecological Oncology, 2020, 41(4): 541-544.
[5] Krittiya Somaketarin, Charuwan Tantipalakorn, Kittipat Charoenkwan, Prapaporn Suprasert, Jatupol Srisomboon. Survival outcomes of sex cord-stromal tumors of the ovary[J]. European Journal of Gynaecological Oncology, 2020, 41(4): 563-568.
[6] Sigit Purbadi, Gregorius Tanamas, Lisa Novianti. Advanced stage ovarian cancer survival in Jakarta[J]. European Journal of Gynaecological Oncology, 2020, 41(4): 587-590.
[7] Terumi Tanigawa, Maki Matoda, Yoichi Aoki, Hidetaka Nomura, Sanshiro Okamoto, Kohei Omatsu, Hiroyuki Kanao, Nobuhiro Takeshima. A case of recurrent smooth muscle tumor of uncertain malignant potential with abdominal dissemination after morcellation[J]. European Journal of Gynaecological Oncology, 2020, 41(4): 648-650.
[8] Chenchen Zhu, Hanyuan Liu, Zhen Shen, Yanhu Xie, Tianjiao Zhang, Björn Nashan, Dabao Wu, Ying Zhou. Treatment and survival outcomes from epithelial ovarian cancer in women aged 65 years or older[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 415-421.
[9] Ming Wang, Shi-Hui Meng, Yu-Mei Wu. Ovarian conservation without postoperative radiation improved survival outcomes in patients with stage i uterine leiomyosarcoma[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 422-431.
[10] Xiaofeng Xu, Xuan Zhou, Yijin Wang, Tao Liu, Jian Fu, Qian Yang, Jun Wu, Huaijun Zhou. Survival-associated transcriptome analysis in ovarian cancer[J]. European Journal of Gynaecological Oncology, 2020, 41(3): 455-461.
[11] M.E. Căpîlna, B. Szabo, J. Becsi, M. Morariu, M. Gheorghe, S.L. Kiss, B. Moldovan. Surgical complications and survival after pelvic exenteration: our experience following 60 procedures[J]. European Journal of Gynaecological Oncology, 2020, 41(2): 171-175.
[12] Can Fang, Yan Zhao, Kezhen Li, Danhui Weng, Peng Wu, Gang Chen, Ding Ma, Juncheng Wei. Diabetes mellitus and epithelial ovarian cancer in Chinese women: a retrospective cohort study[J]. European Journal of Gynaecological Oncology, 2020, 41(2): 260-264.
[13] S. Srdelić Mihalj, V. Čapkun, I. Kuzmić-Prusac. High-grade endometrial cancer survival (endometrioid to non-endometrioid histology comparison)[J]. European Journal of Gynaecological Oncology, 2020, 41(1): 16-22.
[14] Z. Xu, H. Wen, Q. Xue. Successful pregnancy achieved by in vitro fertilization after fertility-preserving treatments in an infertile woman with borderline ovarian tumor and endometrial complex atypical hyperplasia: a case report[J]. European Journal of Gynaecological Oncology, 2020, 41(1): 126-129.
[15] Y.-S. Kwon, K. S. Im, S. B. Yoo, W. I. Kim. Two cases of uterus-conserving treatment for early stage endometrial cancer[J]. European Journal of Gynaecological Oncology, 2020, 41(1): 145-147.
No Suggested Reading articles found!