Oncological safety of laparoscopic surgery for women with apparent early-stage uterine serous carcinoma: A multi-institutional retrospective cohort study.

OBJECTIVE The purpose of this study was to compare the long-term survival outcomes of patients with apparent early-stage uterine serous carcinoma (USC) who underwent laparoscopic staging surgery with those who underwent open surgical staging. METHODS A total of 295 patients from four Chinese teaching hospitals were included. Overall survival (OS) and disease-free survival (DFS) were estimated and compared using the Kaplan-Meier method and the log-rank test among patients after laparoscopic surgery or open surgery. The Cox proportional hazards regression model was applied to adjust for potential confounding factors. RESULTS For patients with apparent early-stage USC, laparoscopic surgery was associated with deteriorated DFS (HR: 1.83, 95% CI, 1.15-2.93, P=0.012), and there was no significant difference in OS between the two groups (HR: 1.74, 95% CI, 0.99-3.08, P=0.056). However, after adjusting for potential confounding factors, the surgical approach was not an independent prognostic factor for DFS (aHR: 1.16, 95% CI, 0.63-2.12, P=0.636) and OS (aHR: 1.11, 95% CI, 0.52-2.38, P=0.794) in apparent early-stage USC. CONCLUSION For apparent early-stage USC, laparoscopic surgery is safe. This needs to be confirmed by future prospective clinical trials.