1. The Impact of Intrauterine Manipulators on Outcome and Recurrence Patterns of Endometrial Cancer Patients Undergoing Minimally Invasive Surgery.
- Author
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Laskov, Ido, Michaan, Nadav, Zeng, Xing, Salvador, Shannon, Lau, Susie, Gilbert, Lucy, Gotlieb, Walter H., and Kessous, Roy
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RISK assessment , *HYSTERECTOMY , *CANCER relapse , *RESEARCH funding , *MINIMALLY invasive procedures , *CANCER patients , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *ENDOMETRIAL tumors , *ADJUVANT chemotherapy , *MEDICAL records , *ACQUISITION of data , *WOMEN'S health , *CONFIDENCE intervals , *PROGRESSION-free survival , *DISEASE risk factors - Abstract
Objective: To evaluate the use of manipulators on the outcome of women who had minimally invasive surgery for endometrial cancer. Methods: Retrospective analysis of patients operated with or without an intrauterine manipulator. Results: Six hundred ninety-nine patients were included. The median follow-up was 44 months (range, 29–67). Nineteen (8.8%) patients had positive cytology in the manipulator group versus 21 (4.4%) in the comparison group (p = 0.02). Total recurrence rate was similar between the groups (12.3% vs. 11.9%; p = 0.8). Vaginal vault recurrence was the most common site of recurrence with higher incidence in the manipulator group (4.5% vs. 1.3%; p = 0.007). Subgroup analysis of low-risk patients who did not receive adjuvant treatment showed higher recurrence rate (8.3% vs. 3%; p = 0.023) and worse disease-free survival (p = 0.01) for the manipulator group. After controlling for other variables, the use of a manipulator did not affect the risk of recurrence for the whole cohort (hazard ratio [HR], 1.28; confidence interval [95% CI], 0.7–2.1, p = 0.3) and for the low-risk subgroup of patients who did not receive adjuvant treatment (HR, 2.47; 95% CI, 0.8–7, p = 0.08). Conclusion: The use of a manipulator increases the risk of positive cytology as well as vaginal vault recurrences, but it does not reduce the overall survival of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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