loading page

The effect of intrauterine manipulator on oncological outcome in early-stage, low-grade endometrial cancer: A retrospective cohort study
  • +4
  • Yexin Ye,
  • Maite Timmermans,
  • Maaike van der Aa,
  • Saskia le Cessie,
  • Trudy N. Jonges,
  • Julienne A. Janse ,
  • Kees Gerestein
Yexin Ye
Universitair Medisch Centrum Utrecht Divisie Beeld, Integraal Kankercentrum Nederland
Author Profile
Maite Timmermans
Leids Universitair Medisch Centrum Afdeling Gynaecologie, Integraal Kankercentrum Nederland
Author Profile
Maaike van der Aa
Integraal Kankercentrum Nederland
Author Profile
Saskia le Cessie
Leids Universitair Medisch Centrum Afdeling Klinische Epidemiologie
Author Profile
Trudy N. Jonges
Universitair Medisch Centrum Utrecht Afdeling Pathologie
Author Profile
Julienne A. Janse
Leids Universitair Medisch Centrum Afdeling Gynaecologie
Author Profile
Kees Gerestein
Universitair Medisch Centrum Utrecht Divisie Beeld

Corresponding Author:[email protected]

Author Profile

Abstract

Objective To evaluate the influence of intrauterine (IU) or non-IU manipulators on oncological outcome in early-stage, low-grade endometrioid endometrial cancer (EEC). Design Retrospective cohort study Setting Nationwide population-based study in the Netherlands Population Women with FIGO stage I, low-grade EEC who received total laparoscopic hysterectomy between 2010 and 2020. Methods Patient data were identified from the Netherlands Cancer Registry. Data regarding hospital manipulator preferences were retrieved through an online survey. Patients were categorized based on hospital manipulator preference. Survival analyses were performed using univariable and multivariable cox regression analysis. Main outcome measures Recurrence of cancer, disease-free survival (DFS), overall survival (OS), site of recurrence, and manipulator preference according to type of hospital. Results Of the total study population (N = 5,205), 1524 (29.3%) patients underwent surgery in hospitals that used non-IU manipulators and 3681 (70.7%) in hospitals that used IU manipulators. Recurrence of cancer was experienced by 195 patients, 49 (3.2%) in the non-IU group and 146 (4.0%) in the IU group. No significant difference in site of recurrence was observed (p=0.778). After adjusting for potential confounders, type of uterus manipulator did not affect DFS (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.78–1.11) and OS (HR 0.90, 95% CI 0.75–1.09). Conclusion IU manipulators are not inferior to non-IU manipulators with respect to oncological outcome in early-stage, low-grade EEC.