Open hysterectomy surgery is still performed on most US women with endometrial cancer even though complications rates are on the rise and the procedure is expensive, according to a retrospective cohort study involving nearly 9,800 women. Additionally, surgical care disparities exist along racial, geographical, and cancer volume lines.

Investigators looked at participants who underwent hysterectomy in 2012 and 2013. 52% underwent open and 48% minimally invasive hysterectomy.

~4 in every 10 patients were treated at low-volume hospitals. Those in high-volume hospitals were less likely to undergo open surgery than those in low-volume hospitals.

Open surgery was more common in:

• Rural vs urban teaching hospitals.

• Government vs nonprofit hospitals.

• Blacks and other non-whites vs whites.

Patients who had open surgery were nearly 3 times as likely to experience perioperative complications. Plus, the procedure cost more than $1,200 more per case.

Investigators estimated that performing minimally-invasive surgery in 80% of the participants might have avoided ~2,700 complications and saved ~$19 million.

Citation: Mannschreck D, Matsuna R, Moriarty J, 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.