Page 155 - EJMO-9-3

Eurasian Journal of Medicine

and Oncology

ORIGINAL RESEARCH ARTICLE
Revisiting the role of the Pfannenstiel incision in

early-stage endometrial cancer

Cem Yagmur Ozdemir * , Hasan Eroğlu 3 , Necat Cağatay Sezer 3 ,
1,2
Nayif Çicekli 2,4 , Derya Yeğin Aksu 5 , and Dağıstan Tolga Arioz 2
1 Department of Gynecological Oncology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
2 Department of Gynecological Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences
University, Afyonkarahisar, Turkey
3 Department of Gynecology and Obstetrics, Faculty of Medicine, Afyonkarahisar Health Sciences
University, Afyonkarahisar, Turkey
4 Department of Gynecological Oncology, Erzurum City Hospital, Erzurum, Turkey
5 Department of Pathology, Faculty of Medicine, Afyonkarahisar Health Sciences University,
Afyonkarahisar, Turkey

Abstract

Introduction: Endometrial cancer is the most common gynecologic malignancy in
developed countries, and the optimal surgical approach in early-stage cases remains
a subject of ongoing clinical debate.
Objective: This study aims to compare laparoscopy and Pfannenstiel incision in early-
stage, low-grade endometrial cancer (EC) surgery.
Methods: A retrospective study was conducted on the records of 224 patients
diagnosed with EC between April 2010 and April 2024. Only patients with stage I and
*Corresponding author: grade I-II endometrioid type EC were included in the study. After excluding 94 patients
Cem Yagmur Ozdemir
(cemyagmur.ozdemir@saglik.gov.tr) with non-endometrioid histology, stage II-IV disease, grade 3 tumors, and synchronous
tumors, 130 patients were included in the final analysis. Participants were categorized
Citation: Ozdemir CY, Eroğlu H, into two groups: Group 1 (63 patients who underwent surgery through Pfannenstiel
Sezer NC, Çicekli N, Aksu DY,
Arioz DT. Revisiting the role of the incision) and Group 2 (67 patients who underwent laparoscopic surgery).
Pfannenstiel incision in early-stage Results: The median overall survival (OS) was 48 months (range: 12 – 168) and
endometrial cancer. Eurasian J Med the median disease-free survival (DFS) was 47 months (range: 8 – 168). During the
Oncol. 2025;9(3):147-154.
doi: 10.36922/EJMO025150106 follow-up period, 20 patients died and 8 patients experienced disease recurrence. The
overall OS rate was 84.6%, and the DFS was 93.8%. When comparing groups, the OS
Received: April 11, 2025
was 85.7% in Group 1 and 83.6% in Group 2 (p=0.12). The DFS rate was significantly
Revised: May 7, 2025 higher in Group 1 compared to Group 2 (96.8% vs. 91%; p=0.037).
Accepted: May 27, 2025 Conclusion: This study highlights the continued relevance of staging surgery with the
Pfannenstiel incision in early-stage EC patients with vaginal stenosis, morbid obesity
Published online: June 19, 2025
unsuitable for trocar insertion, a history of multiple abdominal surgeries, inability to
Copyright: © 2025 Author(s). insert a manipulator, an enlarged normal uterus, or suspected pelvic adhesions.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, Keywords: Endometrial cancer; Laparoscopy; Pfannenstiel incision
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience Endometrial cancer (EC) is the most common gynecological cancer in middle- and
Publishing remains neutral with high-income countries, and its prevalence is increasing worldwide. While surgical
1
regard to jurisdictional claims in
published maps and institutional staging is the cornerstone of EC management, hysterectomy is considered one of the
2,3
affiliations. best treatment options for patients with nonmetastatic disease. Hysterectomy is often

Volume 9 Issue 3 (2025) 147 doi: 10.36922/EJMO025150106