Laparoscopic hysterectomy for endometrial cancer that is confined to the uterus is associated with less pain, shorter hospital stays, faster recovery, and better quality of life when compared with total abdominal hysterectomy, according to the results of two studies published in The Lancet Oncology.
Endometrial cancer is cancer of the lining of the uterus. It is the most frequently diagnosed gynecologic cancer in the United States, but long-term survival rates are high for endometrial cancer that is detected and treated early. Standard treatment for endometrial cancer consists of total abdominal hysterectomy (removal of the uterus) and bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries). A total laparoscopic hysterectomy (TLH) is less invasive than total abdominal hysterectomy (TAH). The laparoscopic procedure takes longer; researchers are evaluating whether it is associated with fewer complications.
Two studies—a Dutch study and an Australian study—compared TLH and TAH in women with Stage I endometrial cancer. Although the complication rates were similar between the two procedures, laparoscopic surgery appeared to be associated with better quality of life. In the Dutch study, researchers found that TLH was associated with less blood loss, less use of pain medication, and shorter hospital stays. In the Australian study, researchers found that the laparoscopic surgery was associated with better quality of life than TAH during both early and late postoperative phases. Quality of life was still improved six months after surgery.
Neither study has reported survival data yet. It is also important to note that not all patients with early endometrial cancer are candidates for TLH. Nevertheless, for women who are eligible for the procedure and who receive care from an experienced surgeon, TLH may provide some quality-of-life benefits.
 Janda M, Gebski V, Brand A, et al. Quality of life after total laparoscopic hysterectomy versus total abdominal hysterectomy for stage I endometrial cancer (LACE): A randomized trial. The Lancet Oncology [early online publication]. July 17, 2010.