• Licerio Miguel, Julio Cesar Rosa E Silva, Omero Benedito Poli Neto, Daniel Guimarães Tiezzi, Jurandyr Moreira de Andrade, and Francisco Jose Candido Dos Reis.
• Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Ginecologia e Obstetrícia - Ribeirão Preto (SP), Brazil.
• Rev Assoc Med Bras (1992). 2021 Jun 1; 67 (5): 753-758.

ObjectiveA surgery is essential for the management of early endometrial carcinoma. Due to the comorbidities associated with the disease, the complications of surgery are common. Laparoscopic surgery may reduce surgical complications but also have oncological risks. We aimed to compare recurrence and overall survival (OS) associated with laparoscopy and laparotomy for early endometrial cancer.MethodsWe included women treated for presumed early endometrial carcinoma at the Clinics Hospital of Ribeirão Preto Medical School from January 1998 to December 2017. We designed a 1:2 propensity score-matched case-control and compared the patients' characteristics, short-term outcomes, recurrence, and OS.ResultsA total of 252 women were included in this study, 168 underwent laparotomy, and 84 underwent laparoscopy. The two groups were well balanced according to most of the variables, and obesity was a characteristic of patients in both groups. Laparoscopy was associated with increased surgical time (194.7 min vesus 165.6 min; p<0.001) and reduced rate of surgical complications (6.5% versus 0; p=0.038). Laparoscopic surgery was not associated with the risk of tumor recurrence (HR: 0.41, 95%CI 0.14-1.19, p=0.100) or all-cause mortality (HR: 0.49, 95%CI 0.18-1.35, p=0.170).ConclusionLaparoscopy was safe in terms of oncological outcomes and was associated with a lower rate of surgical complications. Our data support the use of minimally invasive surgery as the preferential approach in the management of early endometrial carcinoma.

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