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Similar Surgical Outcomes Seen for Endometrial Cancer


 

Major Finding: The median length of hospital stay was 1 day for robotically assisted laparoscopies and 2 days for standard laparoscopies. This difference was significant, with 71% of RBT patients discharged on postoperative day 1, vs. only 20% of LSC patients.

Data Source: A study comparing 153 RBTs and 214 LSCs in women with endometrial cancer.

Disclosures: Dr. Leitao is a consultant for Genzyme. He has also received financial support from Intuitive Surgical Inc.

SAN FRANCISCO — Surgical outcomes for patients with endometrial cancer were similar regardless of whether they received robotically assisted laparoscopic surgery or standard transperitoneal laparoscopic surgery, but the robotically assisted approach lessened the postoperative hospitalization time, according to a poster presented at the annual meeting of the Society of Gynecologic Oncologists.

Dr. Mario M. Leitao Jr. and colleagues at Memorial Sloan-Kettering Cancer Center in New York compared 153 robotically assisted laparoscopies (RBTs) and 214 standard laparoscopies (LSCs) in women with endometrial cancer. The surgeries were performed between May 2007 and August 2009, and demographics were similar between the two groups.

The median pelvic, para-aortic, and total nodal counts for RBTs were 14, 6, and 21, respectively, compared with 16, 5, and 23 for LSCs.

Conversions to laparotomy were similar between the RBT and LSC groups (10% vs. 14%).

Operating room time (ORT) was measured from patient arrival to exit from the OR, and operative time was measured from skin incision to full surgical closure. The median ORT was significantly longer in the RBTs vs. LSCs (315 minutes vs. 268 minutes). Similarly, the median operative time was significantly longer in the RBTs vs. LSCs (235 minutes vs. 194 minutes).

But the investigators did see a learning curve with regard to RBTs. “More experienced RBT surgeons had significantly shorter ORTs,” Dr. Leitao and associates noted.

The median length of hospital stay was 1 day for RBTs and 2 days for LSCs. This difference was significant, with 71% of RBT patients discharged on postoperative day 1, vs. only 20% of LSC patients.

In addition, transfusion rates were similar for both groups, but the median estimated blood loss was significantly lower in the RBT patients vs. LSC patients (75 mL vs. 100 mL). The median change from preoperative to postoperative hemoglobin was significantly lower in RBT patients vs. LSC patients (−0.5 g/dL vs. −0.7 g/dL), and the median change from preoperative to postoperative hematocrit was significantly lower in RBT patients vs. LSC patients (−1.35% vs. −2.3%). These changes are not likely clinically significant, but they may reflect the additional precision achieved in the RBT procedures, they noted.

“Both RBT and LSC approaches are feasible and result in good outcomes in patients with endometrial cancer,” they said.

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