Total Laparoscopic Hysterectomy (TLH) vs. Total Abdominal Hysterectomy (TAH) for the Treatment of Endometrial Cancer (2007–2009)
The LACE study is a clinical trial comparing two types of surgery for women with early-stage cancer of the inner lining of the uterus, known as endometrial cancer. Treatment for endometrial cancer involves removal of the uterus, tubes, ovaries and lymph nodes. Traditionally this has been performed by open surgery via an abdominal incision. Open surgery is effective for endometrial cancer, but it is highly invasive, resulting in visible scarring, tissue damage, blood loss and a fairly high risk of complications. Laparoscopic surgery, commonly referred to as keyhole surgery, is a new approach to removing the uterus, tubes, ovaries and lymph nodes. Preliminary results from this less invasive surgery have been extremely encouraging. Laparoscopic surgery is practical and safe in treating endometrial cancer, while also resulting in less tissue damage, lower blood loss, less pain and a shorter recovery period in hospital.
The LACE study aims to give definitive answers about the results offered by laparoscopic surgery in treating women with early stage endometrial cancer. The primary aim is to investigate whether the treatment of endometrial cancer using laparoscopic surgery is as good as that using open surgery. Secondary aims look at whether laparoscopic surgery provides more benefits compared to open surgery for endometrial cancer, such as:
- improvements in the quality of life post-surgery,
- reduced number of early and late surgery-related complications,
- shorter stays in hospital,
- fewer blood transfusions required,
- less pain post-surgery, and hence fewer pain-killers.
The LACE study is already under way, with recruitment on target for Stage 1. This application seeks funding for Stage 2, to expand recruitment from 2007. The outcomes of the trial will have a significant bearing on the future choice of treatment for endometrial cancer. Therefore the study will impact many patients around the world, including ~2000 women every year in Australia.