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Full length article| Volume 266, P169-174, November 2021

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Factors predicting morbidity in surgically-staged high-risk endometrial cancer patients

Published:September 28, 2021DOI:https://doi.org/10.1016/j.ejogrb.2021.09.029
Factors predicting morbidity in surgically-staged high-risk endometrial cancer patients
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      Abstract

      Objective

      To investigate factors predicting the risk of developing 90-day postoperative complications and lymphatic-specific morbidity in patients undergoing surgical staging for high-risk endometrial cancer.

      Methods

      This is a multi-institutional retrospective cohort study. Patients affected by apparent early-stage high-risk endometrial cancer (endometrioid FIGO grade 3 with deep myometrial invasion and non-endometrioid endometrial cancer) undergoing surgical staging between 2007 and 2019. Complications were graded according to the Clavien-Dindo classification system. Martin criteria were applied to improve quality of complications reporting.

      Results

      Charts of 279 patients were evaluated. Lymphadenectomy, sentinel node mapping (SNM), and SNM followed by back-up lymphadenectomy were performed in 83 (29.7%), 50 (17.9%), and 146 (52.4%) patients, respectively. The former group of patients included 13 patients who had lymphadenectomy after the failure of the SNM technique. Thirteen (4.6%) patients developed severe postoperative events (grade 3 or worse). At multivariate analysis, body mass index (OR: 1.08 (95%CI: 1.01, 1.17)) and open abdominal surgery (OR: 2.27 (95%CI: 1.02, 5.32)) were the two independent factors predictive of surgery-related morbidity. Seven severe lymphatic complications occurred. The adoption of laparoscopic approach (p < 0.001, log-rank test) and SNM (p = 0.038, log-rank test) correlated with a lower risk of developing surgery-related events. Independently, open abdominal surgery was associated with an increased risk of developing lymphatic morbidity (OR: 37.4 (95%CI: 4.38, 319.5); p = 0.001).

      Conclusion

      The adoption of the laparoscopic approach and SNM technique were associated with lower 90-day complication rates than open surgery in high-risk endometrial cancer undergoing staging surgery.

      Keywords

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      Article info

      Publication history

      Published online: September 28, 2021
      Accepted: September 26, 2021
      Received in revised form: September 23, 2021
      Received: July 30, 2021

      Identification

      DOI: https://doi.org/10.1016/j.ejogrb.2021.09.029

      Copyright

      © 2021 Elsevier B.V. All rights reserved.

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