Keyhole surgery a ‘better approach’ for women with early stage womb cancer

In collaboration with the Press Association

Survival in women who have less invasive surgery for early-stage womb cancer is just as good as traditional surgery, an Australian study has found.

“This is very positive news for this group of patients, who did as well as those who had traditional surgery based on their survival and the disease not coming back"Professor Arnie Purushotham, Cancer Research UK

Researchers from the University of Queensland found there was no difference in survival among women who received either a laparoscopic hysterectomy or an abdominal hysterectomy for stage one endometrial cancer.

Laparoscopic, or keyhole surgery, is less invasive, meaning patients can recover quicker following the procedure.

Researchers randomly assigned 760 women to one of two surgical techniques and followed their progress for an average of 4.5 years after surgery.

More than eight in 10 women remained cancer free at the end of the follow-up period for both surgical techniques, according to results published in the journal JAMA.

The number of patients whose cancer had come back was also similar in the two groups.

Professor Arnie Purushotham, senior clinical adviser at Cancer Research UK, said: “The results of this study show that this less invasive surgical technique is a better approach for women with early stage endometrial cancer.”

“This is very positive news for this group of patients, who did as well as those who had traditional surgery based on their survival and the disease not coming back.”

Endometrial cancer – also known as uterine or womb cancer – is the most common gynaecological cancer in developed countries and is the 4th most common cancer in women in the UK.

Surgical treatment involves removing the uterus, fallopian tubes, ovaries and lymph nodes. This can be done through either an abdominal hysterectomy or a laparoscopic hysterectomy.

An abdominal hysterectomy is an invasive procedure that involves an incision across the stomach.

The keyhole approach involves very small cuts in the patient’s abdomen. A small video camera and surgical equipment are inserted through the incisions to remove the organ.

Purushotham stressed the speed with which patients recover from keyhole surgery, combined with the latest survival results, make this a better approach for patients.

“We already knew that patients can recover more quickly following this less invasive surgical approach; they return home earlier and get back to normal activities sooner,” he said.

“We now also know that survival and remaining free from disease is the same for these patients too.”

Purushotham suggested the benefits of less invasive surgery went beyond the individual patient.

“These factors also mean that the health system benefits overall too,” he said, adding that this was due to “better outcomes for patients” and a “lower cost of treatment.” 

References

Janda, M., et al. (2017). Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival Among Women With Stage I Endometrial Cancer. JAMA, 317 (12) DOI: 10.1001/jama.2017.2068