Top

Published in:

Open Access 01-12-2018 | Original Article

Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade

Authors: Tim Wollinga, Nicole P. M. Ezendam, Florine A. Eggink, Marieke Smink, Dennis van Hamont, Brenda Pijlman, Erik Boss, Elisabeth J. Robbe, Huy Ngo, Dorry Boll, Constantijne H. Mom, Maaike A. van der Aa, Roy F. L. P. Kruitwagen, Hans W. Nijman, Johanna M. A. Pijnenborg

Published in: Gynecological Surgery | Issue 1/2018

Abstract

Background

Laparoscopic hysterectomy (LH) for the treatment of early-stage endometrial carcinoma/cancer (EC) has demonstrated to be safe in several randomized controlled trials. Yet, data on implementation of LH in clinical practice are limited. In the present study, implementation of LH for EC was evaluated in a large oncology network in the Netherlands.

Results

Retrospectively, a total of 556 EC patients with FIGO stage I-II were registered in the selected years. The proportion of LH gradually increased from 11% in 2006 to 85% in 2015. LH was more often performed in patients with low-grade EC and was not related to the studied patient characteristics. The introduction of TLH was frequently preceded by LAVH. Patients treated in teaching hospitals were more likely to undergo a LH compared to patients in non-teaching hospitals. The conversion rate was 7.7%, and the overall complication rates between LH and AH were comparable, but less postoperative complications in LH.

Conclusions

Implementation of laparoscopic hysterectomy for early-stage EC increased from 11 to 85% in 10 years. Implementation of TLH was often preceded by LAVH and was faster in teaching hospitals.

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386. https://doi.org/10.1002/ijc.29210 CrossRefPubMed

Boll D, Karim-Kos HE, Verhoeven RH, Burger CW, Coebergh JW, Van De Poll-Franse LV et al (2013) Increased incidence and improved survival in endometrioid endometrial cancer diagnosed since 1989 in the Netherlands: a population based study. Eur J Obstet Gynecol Reprod Biol 166:209–214. https://doi.org/10.1016/j.ejogrb.2012.10.028 CrossRefPubMed

Frost JA, Webster KE, Bryant A, Morrison J (2015) Lymphadenectomy for the management of endometrial cancer. Cochrane Database Syst Rev 9:CD007585. https://doi.org/10.1002/14651858.CD007585 pub3

Reich H, DeCaprio J, McGlynn F (1989) Laparoscopic hysterectomy. J Gynecol Surg 5:213–216. https://doi.org/10.1089/gyn.1989.5.213 CrossRef

Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R et al (2009) Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003677 pub4

Janda M, Gebski V, Forder P, Jackson D, Williams G, Obermair A (2006) Total laparoscopic versus open surgery for stage 1 endometrial cancer: the LACE randomized controlled trial. Contemp Clin Trials 27:353–363. https://doi.org/10.1016/j.cct.2006.03.004 CrossRefPubMed

Mourits MJE, Bijen CB, Arts HJ, ter Brugge HG, van der Sijde R, Paulsen L et al (2010) Safety of laparoscopy versus laparotomy in early-stage endometrial cancer: a randomised trial. Lancet Oncol 11:763–771. https://doi.org/10.1016/S1470-2045(10)70143-1 CrossRefPubMed

Bouwman F, Smits A, Lopes A, Das N, Pollard A, Massuger L et al (2015) The impact of BMI on surgical complications and outcomes in endometrial cancer surgery—an institutional study and systematic review of the literature. Gynecol Oncol 139:369–376. https://doi.org/10.1016/j.ygyno.2015.09.020 CrossRefPubMed

Reeves KW, Carter GC, Rodabough RJ, Lane D, McNeeley SG, Stefanick ML et al (2011) Obesity in relation to endometrial cancer risk and disease characteristics in the Women’s Health Initiative. Gynecol Oncol 121:376–382CrossRefPubMedPubMedCentral

10.

Janssen PF, Brölmann HAM, Huirne JAF (2013) Causes and prevention of laparoscopic ureter injuries: an analysis of 31 cases during laparoscopic hysterectomy in the Netherlands. Surg Endosc Other Interv Tech 27:946–956. https://doi.org/10.1007/s00464-012-2539-2 CrossRef

11.

Galaal K, Bryant A, Fisher AD, Kew F, Al-Khaduri M, et al. Laparoscopy versus laparotomy for the management of early stage endometrial cancer (review). 2014:2012–4. doi:https://doi.org/10.1002/14651858.CD006655.pub2.Copyright

12.

Pijnenborg JM, ter Haar JF (2011) Innovations in surgery: the role of residents in the implementation of laparoscopic hysterectomy. J Laparoendosc Adv Surg Tech A 21:615–619. https://doi.org/10.1089/lap.2010.0443 CrossRefPubMed

13.

Huang CC, Wu MP, Huang YT (2012) Gynecologists’ characteristics associated with the likelihood of performing laparoscopic-assisted hysterectomy: a nationwide population-based study. Eur J Obstet Gynecol Reprod Biol 161:209–214. https://doi.org/10.1016/j.ejogrb.2011.12.024 CrossRefPubMed

14.

Einarsson JI, Matteson KA, Schulkin J, Chavan NR, Sangi-Haghpeykar H (2010) Minimally invasive hysterectomies—a survey on attitudes and barriers among practicing gynecologists. J Minim Invasive Gynecol 17:167–175. https://doi.org/10.1016/j.jmig.2009.12.017 CrossRefPubMedPubMedCentral

15.

Kolkman W, Trimbos-Kemper TCM, Jansen FW (2007) Operative laparoscopy in the Netherlands: diffusion and acceptance. Eur J Obstet Gynecol Reprod Biol 130:245–248. https://doi.org/10.1016/j.ejogrb.2006.01.019 CrossRefPubMed

16.

Mannschreck DB, Matsuno R, Dowdy SC, Sinno AK, Tanner EJ, Stone RL et al (2016) Poor nationwide utilization of minimally invasive surgery in early-stage uterine cancer: an HCUP-National Inpatient Sample database study. Gynecol Oncol 141:13–14. https://doi.org/10.1016/j.ygyno.2016.04.062 CrossRef

17.

Bogani G, Cromi A, Serati M, Di Naro E, Casarin J, Pinelli C et al (2015) Improving standard of care through introduction of laparoscopy for the surgical management of gynecological malignancies. Int J Gynecol Cancer 25:741–750. https://doi.org/10.1097/IGC.0000000000000406 CrossRefPubMed

18.

Creutzberg CL, van Putten WL, Koper PC, Lybeert ML, Jobsen JJ, Wárlám-Rodenhuis CC et al (2000) Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma. Lancet 355:1404–1411. S0140673600021395 CrossRefPubMed

19.

Nout RA, Smit VT, Putter H, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC et al (2010) Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet 375:816–823. https://doi.org/10.1016/S0140-6736(09)62163-2 CrossRefPubMed

20.

Haltia UM, Bützow R, Leminen A, Loukovaara M (2014) FIGO 1988 versus 2009 staging for endometrial carcinoma: a comparative study on prediction of survival and stage distribution according to histologic subtype. J Gynecol Oncol 25:30–35. https://doi.org/10.3802/jgo.2014.25.1.30 CrossRefPubMedPubMedCentral

21.

Pecorelli S, Zigliani L, Odicino F (2009) Revised FIGO staging for carcinoma of the cervix. Int J Gynecol Obstet 105:107–108. https://doi.org/10.1016/j.ijgo.2009.02.009 CrossRef

22.

Fader AN, Weise RM, Sinno AK, Tanner EJ, Borah BJ, Moriarty JP et al (2016) Utilization of minimally invasive surgery in endometrial cancer care: a quality and cost disparity. Obstet Gynecol 127:91–100. https://doi.org/10.1097/AOG.0000000000001180 CrossRefPubMed

23.

Becker JH, Ezendam NPM, Boll D, Van Der Aa M, Pijnenborg JMA (2015) Effects of surgical volumes on the survival of endometrial carcinoma. Gynecol Oncol 139:306–311. https://doi.org/10.1016/j.ygyno.2015.09.003 CrossRefPubMed

24.

Fanning J, Hossler C (2010) Laparoscopic conversion rate for uterine cancer surgical staging. Obstet Gynecol 116:1354–1357. https://doi.org/10.1097/AOG.0b013e3181fae272 CrossRefPubMed

25.

Bijen CBM, De Bock GH, Vermeulen KM, Arts HJG, Ter Brugge HG, Van Der Sijde R et al (2011) Laparoscopic hysterectomy is preferred over laparotomy in early endometrial cancer patients, however not cost effective in the very obese. Eur J Cancer 47:2158–2165. https://doi.org/10.1016/j.ejca.2011.04.035 CrossRefPubMed

26.

Koskas M, Jozwiak M, Fournier M, Vergote I, Trum H, Lok C et al (2016) Long-term oncological safety of minimally invasive surgery in high-risk endometrial cancer. Eur J Cancer 65:185–191. https://doi.org/10.1016/j.ejca.2016.07.001 CrossRefPubMed

27.

Fader AN, Java J, Tenney M, Ricci S, Gunderson CC, Temkin SM et al (2016) Impact of histology and surgical approach on survival among women with early-stage, high-grade uterine cancer: an NRG Oncology/Gynecologic Oncology Group ancillary analysis. Gynecol Oncol 143:460–465. https://doi.org/10.1016/j.ygyno.2016.10.016 CrossRefPubMedPubMedCentral

28.

Herling SF, Palle C, Møller AM, Thomsen T, Sørensen J (2016) Cost-analysis of robotic-assisted laparoscopic hysterectomy versus total abdominal hysterectomy for women with endometrial cancer and atypical complex hyperplasia. 95:299–308. https://doi.org/10.1111/aogs.12820

29.

Desille-gbaguidi H, Hebert T, Paternotte-villemagne J, Gaborit C (2013) Overall care cost comparison between robotic and laparoscopic surgery for endometrial and cervical cancer. Eur J Obstet Gynecol Reprod Biol 171:348–352. https://doi.org/10.1016/j.ejogrb.2013.09.025 CrossRefPubMed

Title: Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade
Authors: Tim Wollinga
Nicole P. M. Ezendam
Florine A. Eggink
Marieke Smink
Dennis van Hamont
Brenda Pijlman
Erik Boss
Elisabeth J. Robbe
Huy Ngo
Dorry Boll
Constantijne H. Mom
Maaike A. van der Aa
Roy F. L. P. Kruitwagen
Hans W. Nijman
Johanna M. A. Pijnenborg
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: Gynecological Surgery / Issue 1/2018
Print ISSN: 1613-2076
Electronic ISSN: 1613-2084
DOI: https://doi.org/10.1186/s10397-018-1040-x

ACC 2024 Congress

Springer Medicine

Implementation of laparoscopic hysterectomy for endometrial cancer over the past decade

Abstract

Background

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

Didactic lectures versus simulation training: a randomised pilot evaluation of its impact on surgical skill

Comparing self-assessment of laparoscopic technical skills with expert opinion for gynecological surgeons in an operative setting

A long-term cohort study of surgery for recurrent prolapse comparing mesh augmented anterior repairs to anterior colporrhaphy

Correction to: Prevalence and predictors of burnout among obstetrics and gynecology residents in Canada

Cadaveric surgery in core gynaecology training: a feasibility study

Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable