Short-Term Outcomes of Laparoscopic Para-Aortic Lymphadenectomy for Early-Stage High-Grade Endometrial Cancer

Background: Clinical stage IA endometrial cancer (EC) is associated with a medium to high risk of recurrence if the histological subtype is other than grades 1 and 2 (G1/2). Despite the wide use of laparoscopic surgery (LS) for intermediate- to high-risk early EC, its impact on prognosis remains unclear. This study aimed to compare the short-term outcomes of LS and open abdominal surgery (OAS) for intermediate- to high-risk clinical stage IA EC. Methods: This retrospective study included 51 patients with stage IA EC diagnosed as histological types other than endometrioid carcinoma G1/2 and initially treated at our institution between 2013 and 2021. Patient outcomes were compared between LS and OAS groups following total simple hysterectomy. Survival analysis was conducted using the Kaplan–Meier method, and group differences were assessed using the log-rank test. Results: Intra- and postoperative complications (grade 3 or higher) did not significantly differ between LS and OAS. However, LS reduced the frequency of early postoperative complications occurring within 30 days compared to OAS. LS did not cause a significant delay in the initiation of adjuvant therapy, as reflected by the comparable median number of days between surgery and the first adjuvant chemotherapy session in both groups. Moreover, the 3-year recurrence-free and overall survival rates did not significantly differ between groups. Conclusions: These results indicate that short-term outcomes do not significantly vary between LS and OAS when performing simple hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymphadenectomy, and para-aortic lymphadenectomy for early-stage stage IA EC at medium-to-high risk of recurrence.