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Objective: Compare the perioperative outcomes and disease-free survival between minimally invasive and open surgery in women with stage I-II high-risk endometrial cancer. Methods: A retrospective, cohort study was performed involving twenty-four centers from Argentina. Patients with grade 3 endometrioid, serous, clear cell, undifferentiated carcinoma or carcinosarcoma who underwent hysterectomy, bilateral salpingo-oophorectomy, and staging between January 2010-2018 were included. Cox hazard regression analysis and Kaplan-Meier curves evaluated the association of surgical technique with survival. Results: Of 343 eligible patients, 214 (62 %) underwent open surgery and 129 (38 %) underwent laparoscopic surgery. No significant differences were seen between the two groups with respect to greater or equal grade III Clavien-Dindo postoperative complications (11 % in the open surgery group vs 9 % minimally invasive surgery group; P = 0.34) Minimally invasive surgery was not associated with worse disease-free survival at four years (79.14 % [95 % CI 69.42- 86.08] vs 78.80 % [95 % CI 70.61-84.96]), (p = 0.25), even after creating a Cox proportional model (hazard ratio [HR] 1.08 95 % CI 0.63-1.84); (p = 0.76). Conclusion: There was no difference between postoperative complications nor oncologic outcomes comparing minimally invasive and open surgery among patients with high-risk endometrial cancer.
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INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 pandemic coronavirus disease (COVID-19) and the measures taken to lessen its impact have had side effects affecting timely care of other diseases. The aim of this paper is to quantify the impact of the pandemic on the cancer care line in the province of Santa Fe, Argentina. METHOD: It is an observational cross-sectional study comparing the impact on selected variables of the pre-pandemic and intra-pandemic periods. The formula of percentage variation was used to show the differences. The positivity index was calculated and expressed as a percentage. The proportions of both periods were compared through the chi-squared test and its p-value. RESULTS: Reductions were observed in all the variables under study. However, the deeper impact was evident in screening, with 56%-87% decreases in the number of procedures carried out. A 26% reduction was seen in diagnosis. Treatment was the variable with the least impact, with a 3% decrease. DISCUSSION: COVID-19 as well as the measures taken to reduce its impact caused alterations in the cancer care line in the province, with clear differences according to the variable under study. Measures related to cancer screening were displaced, prioritising the care of patients already diagnosed and treated. CONCLUSION: Considering the new increase in the number of COVID-19 cases, it is essential to adapt the healthcare system, and design new innovative strategies to reduce long-term consequences.