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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background: Following the results of the Laparoscopic Approach to Carcinoma of the Cervix (LACC) trial, doubts have arisen about the safety of laparoscopy in the treatment of endometrial cancer. Methods: A retrospective multicenter cohort study which included all endometrial cancer (EC) patients who underwent a hysterectomy in Emilia Romagna hospitals from 2000 to 2019. All cases were revised and classified according to the 2009 International Federation of Gynaecology and Obstetrics (FIGO) staging system. The different impacts of the surgical approach on survival were stratified according to the recurrence risk from the 2016 European Society for Medical Oncology (ESMO)–European Society of Gynaecological Oncology (ESGO) classification system. The clinical characteristics and oncological outcome of patients treated by laparoscopy were compared with those treated by laparotomy. Results: A total of 2402 EC patients were included in the study. The use of laparoscopy has increased over the years, reaching 81% of procedures in 2019. Laparoscopy reduced complications and hospital stay. Laparoscopy was preferred to treat low, intermediate, and intermediate/high-risk patients. Laparoscopy showed no adverse effects on overall survival (OS) in any recurrence risk class. Particularly in high-risk EC patients, laparoscopy was associated with an increased OS in comparison with women treated by laparotomy regardless of the use of adjuvant therapy. Conclusions: Laparoscopy should always be chosen to treat EC of any risk class. The goal is to ensure correct treatment and oncological safety regardless of the surgical approach.

Details

Title
Impact of a Surgical Approach on Endometrial Cancer Survival According to ESMO/ESGO Risk Classification: A Retrospective Multicenter Study in the Northern Italian Region
Author
Mandato, Vincenzo Dario 1   VIAFID ORCID Logo  ; Perrone, Anna Myriam 2   VIAFID ORCID Logo  ; Pirillo Debora 1 ; Ciarlini Gino 1 ; Annunziata Gianluca 1 ; Arena Alessandro 3 ; Alboni Carlo 4 ; Di Monte Ilaria 4 ; Capozzi, Vito Andrea 5 ; Amadori, Andrea 6 ; Martinello Ruby 7 ; Rosati Federica 8 ; Stefanetti Marco 8 ; Palicelli Andrea 9   VIAFID ORCID Logo  ; Santandrea Giacomo 9   VIAFID ORCID Logo  ; Seracchioli Renato 3 ; Berretta, Roberto 5   VIAFID ORCID Logo  ; Aguzzoli Lorenzo 1 ; Torricelli Federica 10   VIAFID ORCID Logo  ; De Iaco Pierandrea 2   VIAFID ORCID Logo 

 Unit of Obstetrics and Gynecologic Oncology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; [email protected] (D.P.); [email protected] (G.C.); [email protected] (G.A.); [email protected] (L.A.) 
 Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; [email protected] (A.M.P.); [email protected] (P.D.I.), Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; [email protected] (A.A.); [email protected] (R.S.) 
 Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; [email protected] (A.A.); [email protected] (R.S.), Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero—Universitaria di Bologna, 40138 Bologna, Italy 
 Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, 41124 Modena, Italy; [email protected] (C.A.); [email protected] (I.D.M.) 
 Department of Obstetrics and Gynecology, University of Parma, 43121 Parma, Italy; [email protected] (V.A.C.); [email protected] (R.B.) 
 Gynecology Unit, Ospedale di Forlì, 47121 Forlì, Italy; [email protected] 
 Section of Obstetrics and Gynecology, Department of Medical Sciences, University of Ferrara, 44124 Ferrara, Italy; [email protected] 
 Gynecological and Obstetrical Unit, Infermi Hospital, 47923 Rimini, Italy; [email protected] (F.R.); [email protected] (M.S.) 
 Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; [email protected] (A.P.); [email protected] (G.S.) 
10  Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; [email protected] 
First page
2261
Publication year
2025
Publication date
2025
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3229141875
Copyright
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.