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Multicenter Study
. 2019 Sep;24(9):1129-1136.
doi: 10.1007/s10147-019-01458-2. Epub 2019 May 8.

Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

Tetsuya Hasegawa  1 , Megumi Furugori  1 , Kazumi Kubota  2 , Mikiko Asai-Sato  2 , Aiko Yashiro-Kawano  3 , Hisamori Kato  3 , Yuka Oi  4 , Hiroyuki Shigeta  4 , Keiko Segawa  5 , Masakazu Kitagawa  6 , Yuko Mine  7 , Haruya Saji  7 , Reiko Numazaki  8 , Yasuyo Maruyama  9 , Emi Ohnuma  10 , Hanako Taniguchi  11 , Ken Sugiura  11 , Etsuko Miyagi  2 , Tatsuya Matsunaga  12 ; Yokohama City University Gynecologic Oncology Research Group (YCUGO-ReG)
Affiliations
Multicenter Study

Does the extension of the type of hysterectomy contribute to the local control of endometrial cancer?

Tetsuya Hasegawa et al. Int J Clin Oncol. 2019 Sep.

Abstract

Objective: To examine the necessity and sufficiency of different types of hysterectomy for the surgical treatment of endometrial cancer.

Methods: This was a multicenter collaborative study conducted by 11 institutions. Among patients with stage I-III endometrial cancer who underwent surgery as the initial treatment (only chemotherapy was provided if adjuvant therapy was needed) from 2001 to 2012, we retrospectively examined the type of hysterectomy, clinicopathological factors, recurrence rate over a maximum period of 5 years, and the site of recurrence. The local recurrence rate was examined by univariate and multivariate analyses.

Results: Among 1335 patients, 982 (73.6%) underwent simple hysterectomy (SH) and 353 (26.4%) underwent modified radical hysterectomy (mRH) and were observed for a mean duration of 51.8 months. No significant difference was observed in the rate of local recurrence between the SH and mRH groups (p = 0.928). In multivariate analysis, clinicopathological factors independently associated with localized recurrence included postmenopausal status [hazard ratio (HR) 5.036, 95% confidence interval (CI) 1.506-16.841, p = 0.009], with stages II (HR 3.337, 95% CI 1.701-6.547, p < 0.001) and III (HR 2.445, 95% CI 1.280-4.668, p = 0.007), vs stage I and histological type 2 (HR 1.610, 95% CI 0.938-2.762, p = 0.001).

Conclusions: For endometrial cancer patients requiring surgery, the selection of a more extensive type of hysterectomy did not reduce the rate of local recurrence. Therefore, there is little significance in performing mRH in such cases.

Keywords: Endometrial cancer; Local recurrence; Type of hysterectomy.

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Conflict of interest statement

All the authors have no conflicts of interest directly relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Local recurrence curves according to the surgical procedure
Fig. 2
Fig. 2
Local recurrence curves by stage according to the surgical procedure
See this image and copyright information in PMC

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