Open Versus Laparoscopic Staging for Uterine Papillary Serous Cancer: Analysis of Perioperative Complications and Survival

Objectives: The aim of this research was evaluation of perioperative, debulking, and survival outcomes in patients with uterine papillary serous cancer (UPSC) managed by open staging (OS) or laparoscopic staging (LS). Materials and Methods: This was an 8-year retrospective review of UPSC cases managed by a single surgeon from June 2007 to May 2015 by either OS or LS. Results: There was a total of 59 patients; 37 OS and 22 LS cases. Conversion rate from LS to OS was 0%. Pathologic stage (p=0.430), median age (age 68 versus age 71; p=0.80), body mass index (30.7 kg/m(2) versus 28.4 kg/m(2); p=0.78), and prior abdominal surgery rate (43% versus 36%; p=0.40) were similar between OS and LS cases. There was no significant difference in operative time (196 minutes versus 216 minutes; p=0.561); however, median estimated blood loss (310 mL versus 175 mL; p=0.048) and hospital stay (4 days versus 1 day; p<0.042) were lower for LS cases. Intraoperative complications (2.7% [1/37] versus 0% [0/22]; p=0.37) and postoperative adverse events (29.7% [11/37] versus 13.6% [3/22]; p=0.160) were similar between OS and LS cases. Neoadjuvant chemotherapy rates were similar for OS and LS cases, (13.5% versus 18.2 %; p=0.45). Optimal debulking was achieved in 89.2% OS and 95.4% LS. Postoperative adjuvant therapy was similar between OS and LS cases: brachytherapy (4.5% versus 0.5%; p=0.36), external beam radiation (30.3% versus 33.3%; p=0.63), adjuvant chemotherapy (71.9% versus 86.4%; p=0.21). Estimated 36-month progression-free survival was almost identical in both arms of the study at 55.3% versus 53.3% (p=0.530). Conclusions: Similar cytoreduction rates and overall and progression-free survival demonstrated that LS for surgical staging of UPSC is feasible.