Oncologic outcomes of robot-assisted laparoscopy versus conventional laparoscopy for the treatment of apparent early-stage endometrioid adenocarcinoma of the uterus Journal Article

   

Authors:	Lim, Y. H.; Dagher, C.; Abu-Rustum, N. R.; Mueller, J. J.; Sonoda, Y.; Zivanovic, O.; Broach, V.; Leitao, M. M. Jr
Article Title:	Oncologic outcomes of robot-assisted laparoscopy versus conventional laparoscopy for the treatment of apparent early-stage endometrioid adenocarcinoma of the uterus
Abstract:	Objective: To compare long-term oncologic outcomes in patients with clinically uterine-confined endometrioid endometrial cancer who underwent surgical staging with robot-assisted (RA) versus conventional laparoscopy. Methods: We performed a retrospective chart review of patients with newly diagnosed, uterine-confined endometrioid endometrial cancer who were treated and had primary surgery at our institution between 1/1/2009–1/1/2018. Clinicopathologic, surgical, and survival data were collected. Appropriate statistical methods were applied. Results: Of 1728 patients identified, 1389 (80.4%) underwent RA and 339 (19.6%) conventional laparoscopy. At diagnosis, median age was 60 years (range, 24–92) and median BMI was 30.2 kg/m2 (range, 15.1–71.5). In the RA group, patients had longer operative time (170 vs 152 min, P < .001), lower conversion rate to laparotomy (0.6% vs 4.7%, P < .001), and a higher proportion had a BMI > 40 kg/m2 (17.2% vs 11.5%, P = .01) and same-day discharge (19.2% vs 5.3%, P < .001). Overall, 93% (RA) and 90% (conventional) of patients underwent lymph node assessment (P = .1). Comparing the RA versus conventional groups, final surgical stage on pathology (P = .6), median follow-up (55.7 vs 52.9 months, P = .4), and rates of perioperative complications (9.9% vs 7.7%, P = .6), recurrence (9.5% vs 7.4%, P = .3), 5-year PFS (88.5% vs 91.0%, P = .3), and 5-year OS (92.5% vs 92.4%, P = .7) were not significantly different. No significant increase in risk of recurrence (HR = 1.2, 95% CI: 0.8–1.9, P = .3) or poorer OS outcomes (HR = 0.9, 95% CI: 0.6–1.4, P = .7) were observed in the RA group. Conclusion: In uterine-confined endometrioid endometrial cancers, surgical staging using RA laparoscopy was not associated with adverse survival outcomes compared to conventional laparoscopy. © 2023 Elsevier Inc.
Keywords:	endometrial cancer; laparoscopy; minimally invasive surgery; outcomes; robotic surgery
Journal Title:	Gynecologic Oncology
Volume:	179
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2023-12-01
Start Page:	152
End Page:	157
Language:	English
DOI:	10.1016/j.ygyno.2023.11.009
PROVIDER:	scopus
PUBMED:	37980770
PMCID:	PMC10872455
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85176945265&doi=10.1016%2fj.ygyno.2023.11.009&partnerID=40&md5=88b58090f227a7853738f1806d1f5e86
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Mario M. Leitao Jr. -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/211394