Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Surgical Care Disparities in Endometrial Cancer

Obstet Gynecol; ePub 2016 Aug 5; Mannschreck, et al

Despite increased complication rates and financial costs, most US women with endometrial cancer continue to be treated with open hysterectomy surgery, according to a recent study. The study, which included 9,799 patients (52.4% underwent open and 47.6% minimally invasive hysterectomy), also found that a disparity in endometrial cancer surgical care exists that is affected by patient race and hospital geography and cancer volumes. Other study highlights:

  • 43.4% of patients were treated at low-volume hospitals (<10 endometrial cancer cases annually).
  • Patients in high-volume vs low-volume hospitals were less likely to undergo open surgery (51.8% vs 58.1%) and more likely to undergo open surgery in rural compared with urban teaching hospitals (75.6% vs 51.1%), government vs nonprofit hospitals (61.3% vs 51.1%), and in patients of black and “other” race (60.5%) compared with white race (49.2%).
  • Open surgery was associated with increased perioperative complications and a $1,243 increase in cost per case compared with minimally invasive approaches.


Mannschreck D, Matsuno RK, Moriarty JP, et al. Disparities in surgical care among women with endometrial cancer. [Published online ahead of print August 5, 2016]. Obstet Gynecol. doi:10.1097/AOG.0000000000001567.