Abstract 554P
Background
Endometrial cancer (EC) is the most frequent gynecological malignancy, and most patients (75%) are diagnosed at an early stage. Surgeons need more reliable evidence to choose the appropriate hysterectomy type for patients with early-stage EC.
Methods
Patients with clinical stage IA endometrial carcinoma who underwent hysterectomy between January 2000 and December 2018 were included from six medical centers. Subsequently, 1:1 propensity-score matching was performed between type A hysterectomy (simple total hysterectomy) and type B/C hysterectomy (modified or radical hysterectomy). Disease-free survival (DFS) and overall survival (OS) were assessed using Kaplan–Meier curves. Cox proportional hazards regression analysis was used to analyze the risk factors for DFS.
Results
A total of 1057 patients were included, of which 960 (92.6%) underwent type A hysterectomy and 97 (9.4%) underwent type B/C hysterectomy. Patients in the type B/C group showed greater estimated blood loss (median 200 vs. 120 mL, P < 0.001), longer postoperative hospital stays (median 19 vs. 11 days, P < 0.001), and more postoperative complications (6.2% vs. 2.0%, P = 0.009). The two groups showed no significant differences in DFS and OS before and after matching (P > 0.05). Multivariate Cox analysis revealed that cervical involvement and lymph node metastasis were prognostic factors for survival.
Conclusions
Radical or modified radical hysterectomy did not affect the clinical prognosis of patients with clinical stage IA endometrial carcinoma. However, these procedures could result in greater blood loss, more postoperative complications, and longer hospital stays. The choice of radical hysterectomy needs to be carefully considered in clinical practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Taishan Scholar Youth Project of Shandong Province (grant number tsqn201812130).
Disclosure
All authors have declared no conflicts of interest.