Title : Survival and surgical outcomes of different approaches to surgical treatment of endometrial cancer: A meta-analysis
Abstract:
Background: The objective of this study was to compare the surgical outcomes and survival rates among patients who underwent laparoscopic hysterectomy (LH), laparoscopic-assisted vaginal hysterectomy (LAVH), robotic hysterectomy (RH), and abdominal hysterectomy (AH) for the treatment of endometrial cancer.
Methods: An extensive literature search was conducted across PubMed, Web of Science, Cochrane Library, and SCOPUS, including articles published up until August 2023. Randomized controlled trials (RCTs) involving endometrial cancer patients who underwent LH, LAVH, RH, or AH were included. The primary outcomes of interest encompassed overall peri-operative and post-operative complications, mortality, recurrence, length of hospital stay (LOS), estimated blood loss (EBL), and operative time (OT). Data extraction and risk of bias assessment were independently conducted by two reviewers.
Results: Out of the retrieved studies, twelve met the inclusion criteria for the systematic review, and seven were deemed suitable for meta-analysis. The results revealed significantly lower EBL and LOS for the LH, LAVH, and RH groups compared to the AH group. Conversely, AH demonstrated a shorter operative time compared to LH, LAVH, and RH. However, there was no significant difference in terms of post-operative complications, mortality, and recurrence rates across the surgical methods.
Conclusions: The findings suggest that LH, LAVH, and RH might represent safer and more efficient surgical options compared to AH for patients with endometrial cancer. However, more robust RCTs with long-term follow-up are necessary to corroborate these findings and further elucidate the comparative effectiveness of these surgical approaches.
Audience Take Away Notes:
- Comparative surgical outcomes: The audience will gain knowledge about the differences in surgical outcomes, such as estimated blood loss, length of hospital stay, and operative time, among LH, LAVH, RH, and AH for endometrial cancer treatment
- Safety and efficiency of surgical options: The presentation highlights that LH, LAVH, and RH may offer safer and more efficient alternatives to AH for patients with endometrial cancer
- Need for further research: The audience will understand the importance of conducting more robust randomized controlled trials with long-term follow-up to validate the findings and gain a better understanding of the comparative effectiveness of different surgical approaches
Implications for the audience:
- Clinical practice: The findings can guide healthcare professionals in selecting the most appropriate surgical approach for patients with endometrial cancer, taking into account factors such as surgical outcomes, safety, and efficiency
- Research and teaching: Other faculty members can use this research as a basis for expanding their own research or teaching in the field of gynecologic oncology or surgical approaches for endometrial cancer
- Improved patient care: The presentation provides practical information that can simplify decision-making for surgeons and healthcare teams, potentially leading to improved patient outcomes, reduced complications, and enhanced patient satisfaction.
- Enhanced surgical planning: The findings can assist in the design and planning of surgical interventions for endometrial cancer, helping surgeons make more informed decisions and potentially improving the accuracy and
- efficiency of their procedures
- Overall, The research presentation offers valuable insights into the comparative effectiveness of different surgical approaches for endometrial cancer, providing knowledge that can be applied by clinicians, researchers, and educators in the field, ultimately benefiting patient care and surgical decision-making.
