Abstract
The aim of this study was to compare oncological effectiveness, morbidity, and perioperative outcomes between minimally invasive surgical staging and open surgical staging for endometrial cancer. This is a retrospective analysis of endometrial cancer patients who were treated in surgical oncology department in our institute between January 2015 and November 2024 (n = 217). The oncological effectiveness and morbidity of the two groups were compared based on disease-free survival, mean operative time, blood loss, lymph node harvest, intraoperative complications, postoperative complications, duration of hospitalization, etc., and the results were analyzed. Statistical analysis was performed using IBMSPSS statistics version 25, and clinical and pathological factors were compared between two groups with Fisher's exact test and Student's t-test for data analysis. Survival analysis was done by Kaplan-Meier method with p ≤ 0.05 considered statistically significant. Out of 217 patients, 93 underwent open surgical staging, while 124 underwent minimally invasive surgical staging. Within the minimally invasive group, 86 patients had laparoscopic surgical staging, and 38 had robotic surgical staging. The mean operative time for the minimally invasive procedure was lower than the open procedure (115 vs 136 min, p = 0.009). Intraoperative blood loss of patients undergoing minimally invasive staging was significantly less than that of laparotomy group (60 vs 140 ml, p = 0.007). There was no statistically significant difference in nodal retrieval between the two groups (13 vs 15, p = 0.09). The mean duration of hospitalization was statistically significantly higher in the laparotomy group than the minimally invasive group (6 vs 4 days, p = 0.005). Kaplan-Meier survival curve showed that the DFS rate at 3 years was more in minimally invasive group compared to open surgical staging (95.2% vs 88.3%, p = 0.003). Minimally invasive surgical staging is oncologically safe for the management of endometrial cancer with better survival rate, less morbidity compared to the open surgical staging with less blood loss, and shorter postoperative stay.