Feigenberg T, Cormier B, Gotlieb WH, et al. - Patients diagnosed with high grade endometrial cancer (HGEC) undergoing minimally invasive surgery (MIS) are noted to be at a significantly increased risk for intra-abdominal recurrence when extraction of a large uterus is performed.

• Among a total of 758 included patients, 157 showed disease recurrence (20.71%) during the median follow-up period of 30.5 months (interquartile range 20–47).

• Risk for intra-abdominal recurrence, but not for extra-abdominal recurrences, increased.

• When extraction of a large uterus is performed, concern of tumor spillage is raised by the pattern of recurrences.

• Risk of single-site abdominal recurrence increased when intra-uterine manipulator was used.