Laparoscopic pelvic lymphadenectomy in patients with early-stage endometrial cancer

Objective: The adoption of laparoscopic surgery to treat gynecological cancer has been very slow in Japan despite the merits of this procedure, including shorter hospital stays, reduced postoperative pain and earlier resumption of activity. We analyzed the safety and feasibility of performing laparoscopic pelvic lymphadenectomy for early-stage endometrial cancer. Methods: Between June and December 2010, we performed laparoscopic pelvic lymphadenectomy in five patients with grade 1 or 2 endometrioid adenocarcinoma confirmed on pathological specimens collected via hysteroscopy and endometrial curettage and expected stage 1A disease based on MRI and CT scans. We analyzed the rates of intraoperative and postoperative complications, operative time, amount of bleeding, number of lymph nodes and pathological findings. Results: We experienced no cases of intraoperative or postoperative complications. The average operative time was 259 minutes (4 hours and 19 minutes), the average amount of blood loss was 159 g and the average number of lymph nodes was 18.2. All cases were confirmed to be endometrioid adenocarcinoma of G1 or G2 with myometrial invasion < 1/2 on pathological examination.Conclusions: We performed laparoscopic lymphadenectomy in five cases of early-stage endometrial cancer without complications. The results suggest the safety and feasibility of performing laparoscopic lymphadenectomy in patients with early-stage endometrioid adenocarcinoma of G1 or G2.