Endometrial cancer: robotic surgery yields fewer complications in Danish study

  • Jørgensen SL & al.
  • JAMA Surg
  • 27 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • The national introduction of minimally invasive robotic surgery (MIRS) increases the proportion of women with early-stage endometrial cancer who undergo minimally invasive surgery (MIS) and reduces the risk for severe complications during a 10-year period.

Why this matters

  • Findings support national programs to promote access to MIS in women with endometrial cancer.

Study design

  • 5654 women with early-stage endometrial cancer underwent total abdominal hysterectomy or MIS during 2005-2015.
  • 3091 patients underwent surgery before introduction of MIRS (group 1), and 2563 received surgery after MIRS introduction (group 2).
  • Funding: University of Southern Denmark; Danish Cancer Society.

Key results

  • Use of MIS increased from 3% in 2005 to 95% in 2015.
  • Patients in group 1 had higher risk for severe complications vs those in group 2 (OR, 1.39; 95% CI, 1.11-1.74).
  • In group 1, 14.1% of women underwent minimally invasive laparoscopic surgery (MILS).
  • In group 2:
    • 50.0% of women received MIRS and 22.2% received MILS.
    • Total abdominal hysterectomy was associated with higher risk for severe complications vs MILS (OR, 2.58; 95% CI, 1.80-3.70) and MIRS (OR, 3.87; 95% CI, 2.52-5.93).
    • Risk for severe complications was not significantly different with MILS vs MIRS (OR, 1.50; 95% CI, 0.99-2.27).

Limitations

  • Observational design.

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