Outcomes of Total Laparoscopic Hysterectomy Versus Total Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy in Endometrial Carcinoma
Abstract
Objective: Management of endometrial carcinoma may involve total hysterectomy with bilateral salpingo-oophorectomy (TH-BSO), performed either laparoscopically or via laparotomy. This evaluation is crucial for assessing recovery and determining appropriate follow-up care in patients with endometrial cancer based on the ECOG Performance Status.
Methods: This retrospective cohort study examined data from patients who underwent THBSO at Dr. Hasan Sadikin Hospital in 2024. The primary outcome measured was ECOG performance status at one month and six months post-surgery. The analysis was conducted using the Mann-Whitney U test to compare ECOG scores between the laparoscopic and laparotomy groups.
Result: Of the 47 patients (28 laparotomies and 19 laparoscopies), the Mann-Whitney U test results for the ECOG score one month postoperatively showed no significant difference between patients who underwent THBSO with laparoscopic and laparotomy techniques (p = 0.921). However, the results of the 6-month postoperative ECOG score test indicated a significant difference between the two groups (p = 0.026), with better outcomes in the laparoscopic group.
Conclusion: ECOG performance status after laparoscopy in endometrial cancer cases was better than after laparotomy.
Abstrak
Tujuan: Penatalaksanaan karsinoma endometrium dapat dilakukan dengan histerektomi total disertai salpingo-ooforektomi bilateral, yang dilakukan baik secara laparoskopi maupun melalui laparotomi. Penilaian ini penting untuk mengevaluasi proses pemulihan dan menentukan tata laksana tindak lanjut yang tepat pada pasien kanker endometrium berdasarkan ECOG Performance Status.
Metode: Studi kohort retrospektif ini menganalisis data pasien yang menjalani HTSOB di RSUP Dr. Hasan Sadikin pada tahun 2024. Luaran utama yang dinilai adalah ECOG performance status satu bulan dan enam bulan postoperatif. Analisis dilakukan menggunakan uji Mann-Whitney U untuk membandingkan skor ECOG antara kelompok laparoskopi dan laparotomi.
Hasil: Dari 47 pasien (28 laparotomi dan 19 laparoskopi), hasil uji Mann-Whitney U terhadap skor ECOG satu bulan postoperatif menunjukkan bahwa tidak terdapat perbedaan bermakna antara pasien yang menjalani HTSOB dengan teknik laparoskopi dan laparotomi (p = 0.921). Sedangkan hasil uji skor ECOG 6 bulan postoperatif menunjukkan bahwa terdapat perbedaan signifikan antara kedua kelompok (p = 0.026), dengan hasil lebih baik pada kelompok laparoskopi.
Kesimpulan: ECOG performance status pasca laparoskopi pada kasus kanker endometrium lebih baik daripada laparotomi.
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Creasman WT. (2014). Endometrial cancer: incidence, prognostic factors, diagnosis, and treatment. Semin Oncol, 41(5), S1–S4. https://doi.org/10.1053/j.seminoncol.2014.07.001
American College of Obstetricians and Gynecologists. (2015). ACOG Practice Bulletin No. 149: Endometrial Cancer. Obstet Gynecol, 125(4), 1006–1026. https://doi.org/10.1097/01.AOG.0000462974.52519.d3
Ferlay J, Ervik M, Lam F, et al. (2024). Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer. https://gco.iarc.who.int/today
Bokhman JV. (1983). Two pathogenetic types of endometrial carcinoma. Gynecol Oncol, 15(1), 10–17. https://doi.org/10.1016/0090-8258(83)90111-7
Kandoth C, Schultz N, Cherniack AD, et al. (2013). Integrated genomic characterization of endometrial carcinoma. Nature, 497(7447), 67–73. https://doi.org/10.1038/nature12113
National Comprehensive Cancer Network. (2024). NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Uterine Neoplasms. Version 1.2024. Plymouth Meeting (PA): NCCN.
Galaal K, Bryant A, Fisher AD, et al. (2012). Laparoscopy versus laparotomy for the management of early stage endometrial cancer. Cochrane Database Syst Rev, 9, CD006655. https://doi.org/10.1002/14651858.CD006655.pub2
Walker JL, Piedmonte MR, Spirtos NM, et al. (2012). Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer. J Clin Oncol, 30(7), 695–700. https://doi.org/10.1200/JCO.2011.38.8645
Oken MM, Creech RH, Tormey DC, et al. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol, 5(6), 649–655. https://doi.org/10.1097/00000421-198212000-00014
Nevadunsky NS, Van Arsdale A, Strickler HD. (2019). Age at menopause and risk of developing endometrial cancer: A systematic review and meta-analysis. Int J Gynecol Cancer, 29(3), 389–397.
Thanapprapasr D. (2025). Age is just a number: Treatment considerations for endometrial cancer in older women. ASCO Post, Jan 25.
Cancer Australia. (2023). Personal Risk Factors for Endometrial Cancer. https://www.canceraustralia.gov.au/cancer-types/endometrial-cancer/what-are-risk-factors-endometrial-cancer/personal.
Kaaks R, Lukanova A. (2001). Energy balance and cancer: the role of insulin and IGF-I. Proc Nutr Soc, 60(1), 91–106.
Cignarella A, Conz L, Sandri M. (1997). Hormonal and genetic risk factors for endometrial cancer. Ann Oncol, 8(Suppl 3), S65–S70.
Lukanova A, Kaaks R. (2005). Endogenous hormones and endometrial cancer: epidemiology and current hypotheses. Cancer Epidemiol Biomarkers Prev, 14(5), 1231–1237.
Mutter GL. (1993). Pathology of premalignant and malignant endometrial changes in the elderly. J Natl Cancer Inst Monogr, (15), 23–26.
Kaaks R, Lukanova A, Kurzer MS. (2002). Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev, 11(12), 1531–1534.
Thangarajah F, et al. (2018). Reproductive factors and risk of endometrial cancer: A comprehensive review. Gynecol Oncol, 150(3), 456–464.
Trabert B, Wentzensen N, Mirabelli D, et al. (2013). Reproductive factors and risk of endometrial cancer: The E3N cohort study. Int J Cancer, 132(6), 1429–1437.
Lurie G, Wilkens LR, Thompson PJ, et al. (2008). Parity and endometrial cancer risk: Does progesterone play a role? Cancer Epidemiol Biomarkers Prev, 17(9), 2549–2556.
Li Y, Chen G, Wang Z, et al. (2023). Comparison of efficacy of single-port versus conventional laparoscopy for myomectomy: A meta-analysis. Arch Gynecol Obstet, 307(3), 675–684. https://pmc.ncbi.nlm.nih.gov/articles/PMC10433900/
Lawrie D, et al. (2019). Laparoscopy versus laparotomy for FIGO stage I ovarian cancer. Cochrane Database Syst Rev, 7(7), CD012390. https://pmc.ncbi.nlm.nih.gov/articles/PMC6464147/
Walker JL, Piedmonte MR, Spirtos NM, et al. (2009). Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: GOG LAP2. J Clin Oncol, 27(32), 5331–5336.
American College of Obstetricians and Gynecologists. (2015). Practice Bulletin No. 149: Endometrial cancer. Obstet Gynecol, 125(4), 1006–1026.
Walker JL, et al. (2020). Laparoscopic management of endometrial cancer. JSLS, 24(1), e2020.00029.
DOI: http://dx.doi.org/10.24198/obgynia.v9i1.1019
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