Laparoscopic hysterectomy supported for early endometrial cancer
medwireNews: The phase III LACE trial shows that total laparoscopic hysterectomy (TLH) for stage I endometrial cancer is equivalent to total abdominal hysterectomy (TAH) with respect to disease-free survival.
Jason Wright (Columbia University, New York, USA) says in an editorial accompanying the research published in JAMA: “This study adds to a growing body of literature that suggests laparoscopic hysterectomy is not only safe, but also the preferred modality of hysterectomy for women with endometrial cancer.”
He believes that “efforts to promote the procedure for women with endometrial cancer should now be a priority.”
At the 4.5-year mark, 81.6% of 407 women randomly assigned to undergo TLH remained disease-free, as did 81.3% of the 353 who underwent TAH, giving a between-group difference of 0.3%, which met the prespecified criteria for equivalence.
The TLH and TAH groups were also comparable in terms of the secondary endpoints of endometrial cancer recurrence (8.1 vs 7.9%) and all-cause mortality (7.4 vs 6.8%).
Given the short-term benefits of the laparoscopic approach, including improved postsurgical recovery and shorter hospital stay, Andreas Obermair (Royal Brisbane and Women’s Hospital, Queensland, Australia) and fellow investigators say that “updated meta-analyses should now be conducted to determine whether [TLH] should become the standard approach” for this patient population.
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