Survival Outcomes of Minimally Invasive Surgery Versus Open Surgery for Early-Stage Uterine Sarcoma: A Single-Institution Retrospective Study

Background: Uterine sarcoma, frequently diagnosed postoperatively, and often misidentified as benign tumor, is commonly managed through minimally invasive surgery (MIS) and tumor morcellation. This study aims to investigate the survival outcomes of MIS for early-stage uterine sarcoma, and investigate the impact of tumor morcellation on oncologic outcomes. Methods: A retrospective study was conducted on 33 patients diagnosed with early-stage uterine sarcoma and were studied from January 2006 to December 2022. Patients were divided into two groups: MIS group and open group. This study assessed the 5-year progression-free survival (PFS) and overall survival (OS) in both groups. Additionally, the study investigated the impact of tumor morcellation on oncology outcomes. Results: The 5-year PFS rates in the MIS and open surgery groups were 42% and 65%, respectively (p = 0.577); the 5-year OS rates were 77% and 56%, respectively (p = 0.125). Sixteen patients had recurrence (48%). The 5-year PFS rates in the morcellated and nonmorcellated groups were 42% and 51%, respectively (p = 0.732); the 5-year overall survival rates were 75% and 68%, respectively (p = 0.584). Conclusions: Although there were not statistically significant differences in survival outcomes between the MIS group and open surgery, intraoperative tumor morcellation may increase peritoneal recurrence risk and negatively affect progression-free survival. Further, a large study is needed to investigate the outcomes of MIS.