ASO Author Reflections: Is It Safe to Use Intrauterine Manipulators in Laparoscopic Surgery for Endometrial Cancer?

Excerpt

Endometrial cancer, the most common gynecologic tumor in developed countries, has a generally favorable prognosis, with an overall 5-year survival rate of 80%. Its primary treatment consists of surgery including total hysterectomy and bilateral salpingo-oophorectomy as well as nodal staging if indicated.¹ Currently, minimally invasive surgery is the standard approach in early-stage endometrial cancer according to evidence showing no compromise in oncologic outcomes but lower morbidity and a shorter hospital stay than with open surgery.² However, only limited data on the oncological safety of the use of intrauterine manipulators are available. There is some evidence that intrauterine manipulation may result in retrograde seeding of the peritoneal cavity with cancer cells,³ and a recently published retrospective trial analyzing 2661 patients showed an association of the use of intrauterine manipulators with higher recurrence rates and worse survival in endometrial cancer.⁴ This study aimed to analyze the association of intrauterine manipulation, peritoneal cytology, and oncologic outcomes for endometrial cancer patients. …