Robot-assisted versus laparoscopic minimally invasive surgery for the treatment of stage I endometrial cancer

Argenta, Peter A.; Mattson, Jordan; Rivard, Colleen; Luther, Elizabeth; Schefter, Alexandra

doi:10.1016/j.ygyno.2022.03.007

Cited by 19 publications

(11 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, there were two cases of recurrences in the RALH group and one in the TLH group. However, follow-up at 10-year intervals should be continued, as another report indicated that patients treated with robotic surgery showed recurrence more frequently and earlier and were more likely to die of cancer than those treated with laparoscopy [23].…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Laparoscopic Hysterectomy for Endometrial Cancer at a Regional Institution: A Retrospective Study

Hiratsuka¹,

Tsuchiya²,

Isono³

et al. 2023

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

Background: Minimally invasive surgeries, such as laparoscopic and robotic surgeries, have been the main treatment methods for stage I endometrial cancer instead of laparotomy. However, minimally invasive surgeries for malignant tumors have not yet been established in many rural hospitals or hospitals with few gynecologists. This study aimed to investigate whether laparoscopic or robotic surgery for stage I endometrial cancer is more sustainable and useful at a rural hospital where a single non-laparoscopic-specialized surgeon performs oncologic surgery and provides outpatient care. Methods: This retrospective case-control study was conducted at our hospital. The study enrolled 65 patients with endometrial cancer who underwent robotic-assisted laparoscopic hysterectomy (RALH) or total laparoscopic hysterectomy (TLH). We compared surgical outcomes such as patient background, operation time, blood loss, and other indices. Results: Exactly 34 patients underwent robotic surgery, and 31 underwent laparoscopic surgery. No severe adverse events required reoperation, conversion to laparotomy, or ureteral injury during either operation. The operation time decreased in patients who underwent robotic surgery compared with those who underwent laparoscopic surgery (193 (140-227) vs. 253 (219-287) min, p < 0.001). In addition, the blood loss volume decreased by half in patients who underwent robotic surgery compared to those who underwent laparoscopic surgery. Significantly more operations were completed by two operators rather than three operators at robotic surgery compared to laparoscopic surgery (59% vs. 26%, p = 0.007). The hospitalization days were 1.5 days shorter in the robotic surgery group than in the laparoscopic surgery group (p < 0.001). Exactly 18 patients underwent robotic surgery with pelvic lymphadenectomy, and 26 underwent laparoscopic surgery with pelvic lymphadenectomy. Patients who underwent robotic surgery required less operation time than those who underwent laparoscopic surgery (226 (199-246) vs. 261 (236-287) min, p = 0.001). Conclusions: In the surgical treatment of stage I endometrial cancer, robotic surgery was associated with a significantly shorter operation time, shorter hospital stay, and no obvious complications. This study proposes that robotic surgery is a promising solution for the sustainable introduction of minimally invasive surgery for stage I endometrial cancer in rural hospitals or hospitals with few gynecologists.

show abstract

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Laparoscopic Hysterectomy for Endometrial Cancer at a Regional Institution: A Retrospective Study

Hiratsuka¹,

Tsuchiya²,

Isono³

et al. 2023

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

show abstract

“…Robotic surgery for the treatment of endometrial cancer has been investigated during the last decade [9,10]. Despite some controversies arising from recent retrospective studies [11,12], minimally invasive approach continues to be the preferred surgical approach for early stage endometrial carcinoma (I/II) according to the ESGO/ESTRO/ESP Guidelines, with total hysterectomy and bilateral salpingo-oophorectomy being recommended [13].…”

Section: Robotic Hysterectomymentioning

confidence: 99%

Level 1 Evidence for Robotic Surgery for Urological and Gynecological Pelvic Cancers: Where do We Currently Stand?

Sighinolfi¹,

Gaia²,

Afonina³

et al. 2023

Clin. Exp. Obstet. Gynecol.

View full text Add to dashboard Cite

Robotic surgery is used for the surgical removal of female pelvic malignancies and encompasses procedures as radical cystectomy and radical hysterectomy. The aim of this paper is to provide an update of level 1 literature evidence about the outcomes of robotic surgery compared to other surgical approaches for the treatment of bladder, endometrial and cervical cancer. A non-systematic search of the PubMed and Scopus databases was conducted to identify peer-reviewed randomized controlled trials (RCTs) comparing surgical approaches for radical cystectomy and hysterectomy. To the purpose of capturing the lastest updates, 2020-2022 literature was reviewed. In the field of radical cystectomy, two RCTs supported the implementation of robotics as a more beneficial approach than open surgery -in terms of faster recovery, less thromboembolic events, less infectious events. In gynecology, despite robotics is accepted for the treatment of early endometrial tumors, the role of minimally invasive surgery (MIS) for the treatment of cervical cancer is still debated, with two recent systematic reviews and meta-analyses reporting conflicting results. Two-decades after the introduction of robotic surgery, there is still a number of current studies evaluating its role for the treatment of urological pelvic malignancies, especially for bladder cancer. The role of robotic surgery alone for the treatment of gynecological malignancies has been scarcely addressed with robotics being mostly evaluated as a part of MIS; updates about MIS for the treatment of cervical cancer continue to be ongoing.

show abstract

“…However, recent studies have questioned the long-term outcomes of RS. More specifically, Argenta et al [ 60 ] reported that in patients with stage I EC, RS is associated with poorer long-term outcomes, compared to the LS group, and led to poorer recurrence-free (Hazard Ratio-HR: 1.41; 95% CI: 1.12, 1.77), OS (HR: 1.39; 95% CI: 1.06, 1.83), and disease-specific survival (HR: 3.51; 95% CI: 2.19, 5.63). The study concludes that possibly, the significance of long-term effects has been underestimated due to positive short-term outcomes [ 60 ], as also highlighted in the British Gynaecological Cancer Society (BGCS) guidelines [ 47 ].…”

Section: Management Of Endometrial Cancermentioning

confidence: 99%

Current Approaches to the Management of Patients with Endometrial Cancer

Kalampokas

Giannis

Kalampokas

et al. 2022

Cancers

View full text Add to dashboard Cite

The incidence of endometrial cancer (EC) is rising and healthcare professionals need to be informed about the latest data on the constant developments in the field of its management. With particular interest in the classification and management of EC, we surveyed current literature, national and international data, and guidelines, as well as the latest studies to present the most recent data regarding the management of EC. It became evident that despite the consensus on low-risk EC, there are still controversies surrounding the management of high-risk EC, especially regarding the role of sentinel lymph node biopsy (SLNB). Our aim is to present the old and new perspectives in the management of EC, the different available surgical routes, the possible desire for fertility preservation, the role of adjuvant therapies and the focus on the advantages and the limitations of the implementation of SLNB in therapeutic strategies. It became evident throughout our search and based on literature data that minimally invasive surgery (MIS) leads to satisfying outcomes, thus becoming gradually the preferred route of surgery, while SLNB could provide essential information and guidance about the overall management needed in cases of both low-risk and high-risk EC.

show abstract

Robot-assisted versus laparoscopic minimally invasive surgery for the treatment of stage I endometrial cancer

Cited by 19 publications

References 21 publications

Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Laparoscopic Hysterectomy for Endometrial Cancer at a Regional Institution: A Retrospective Study

Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Laparoscopic Hysterectomy for Endometrial Cancer at a Regional Institution: A Retrospective Study

Level 1 Evidence for Robotic Surgery for Urological and Gynecological Pelvic Cancers: Where do We Currently Stand?

Current Approaches to the Management of Patients with Endometrial Cancer

Contact Info

Product

Resources

About