Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients

Background: Endometrial cancer, the most common gynecologic malignancy in developed nations, poses substantial treatment challenges, particularly in patients with significant comorbidities or advanced obesity. Purpose: This manuscript introduces an innovative method that employs awake hysteroscopic...

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Main Authors: Michael Lavie, Gilad Rattan, Dana Englander, Shai Ram, Neta Solomon, Nadav Michaan, Dan Grisaru, Ido Laskov
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925000530
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author Michael Lavie
Gilad Rattan
Dana Englander
Shai Ram
Neta Solomon
Nadav Michaan
Dan Grisaru
Ido Laskov
author_facet Michael Lavie
Gilad Rattan
Dana Englander
Shai Ram
Neta Solomon
Nadav Michaan
Dan Grisaru
Ido Laskov
author_sort Michael Lavie
collection DOAJ
description Background: Endometrial cancer, the most common gynecologic malignancy in developed nations, poses substantial treatment challenges, particularly in patients with significant comorbidities or advanced obesity. Purpose: This manuscript introduces an innovative method that employs awake hysteroscopic endometrial laser ablation (HEA) as a palliative treatment for patients with endometrial cancer who were either inoperable or medically unfit to undergo general or regional anaesthesia for conventional therapies. Methods: A retrospective evaluation of patients diagnosed with endometrial cancer at a tertiary center from 2019 to 2024, focusing on those with symptomatic uterine bleeding, who failed previous treatment options and could not undergo surgical or standard palliative interventions due to high surgical risk. Results: In our study, three patients (n = 3) with severe medical conditions—high BMI and poor performance status—underwent awake HEA using a vaginoscopic approach, treating symptomatic vaginal bleeding effectively. The procedure allowed for rapid treatment, minimal recovery time, and enhanced quality of life. Histological analyses post-ablation indicated satisfactory outcomes, contributing to symptom relief and stabilization of patients’ conditions. Conclusion: Our findings highlight the potential of conscious HEA as a palliative management strategy in high-risk patient populations, emphasizing its role when conventional therapies fail. This study underscores the importance of personalized treatment plans and multidisciplinary approaches in managing endometrial cancer, paving the way for further research into the safety and efficacy of HEA in similar cohorts.
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spelling doaj-art-c3f4597ec26f43bcac4372571fea57272025-08-20T02:27:47ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810172810.1016/j.gore.2025.101728Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patientsMichael Lavie0Gilad Rattan1Dana Englander2Shai Ram3Neta Solomon4Nadav Michaan5Dan Grisaru6Ido Laskov7Department of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, Israel; Corresponding author at: Department of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel-Aviv 64239, Israel.Department of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, IsraelSackler School of Medicine, Tel Aviv University, IsraelDepartment of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, IsraelDepartment of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, IsraelDepartment of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, IsraelDepartment of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, IsraelDepartment of Gynecologic Oncology, Lis Hospital for Women, Tel Aviv Medical Center, Israel; Sackler School of Medicine, Tel Aviv University, IsraelBackground: Endometrial cancer, the most common gynecologic malignancy in developed nations, poses substantial treatment challenges, particularly in patients with significant comorbidities or advanced obesity. Purpose: This manuscript introduces an innovative method that employs awake hysteroscopic endometrial laser ablation (HEA) as a palliative treatment for patients with endometrial cancer who were either inoperable or medically unfit to undergo general or regional anaesthesia for conventional therapies. Methods: A retrospective evaluation of patients diagnosed with endometrial cancer at a tertiary center from 2019 to 2024, focusing on those with symptomatic uterine bleeding, who failed previous treatment options and could not undergo surgical or standard palliative interventions due to high surgical risk. Results: In our study, three patients (n = 3) with severe medical conditions—high BMI and poor performance status—underwent awake HEA using a vaginoscopic approach, treating symptomatic vaginal bleeding effectively. The procedure allowed for rapid treatment, minimal recovery time, and enhanced quality of life. Histological analyses post-ablation indicated satisfactory outcomes, contributing to symptom relief and stabilization of patients’ conditions. Conclusion: Our findings highlight the potential of conscious HEA as a palliative management strategy in high-risk patient populations, emphasizing its role when conventional therapies fail. This study underscores the importance of personalized treatment plans and multidisciplinary approaches in managing endometrial cancer, paving the way for further research into the safety and efficacy of HEA in similar cohorts.http://www.sciencedirect.com/science/article/pii/S2352578925000530Endometrial cancerPalliative treatmentHysteroscopic laser ablationMinimally invasive surgeryEndoscopic surgery
spellingShingle Michael Lavie
Gilad Rattan
Dana Englander
Shai Ram
Neta Solomon
Nadav Michaan
Dan Grisaru
Ido Laskov
Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
Gynecologic Oncology Reports
Endometrial cancer
Palliative treatment
Hysteroscopic laser ablation
Minimally invasive surgery
Endoscopic surgery
title Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
title_full Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
title_fullStr Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
title_full_unstemmed Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
title_short Hysteroscopic endometrial laser ablation – A novel approach for palliative management of endometrial cancer in inoperable patients
title_sort hysteroscopic endometrial laser ablation a novel approach for palliative management of endometrial cancer in inoperable patients
topic Endometrial cancer
Palliative treatment
Hysteroscopic laser ablation
Minimally invasive surgery
Endoscopic surgery
url http://www.sciencedirect.com/science/article/pii/S2352578925000530
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