Vincent Lavoue1, Xing Zeng1, Susie Lau1, Joshua Z Press1, Jeremie Abitbol1, Raphael Gotlieb1, Jeffrey How2, Yifan Wang2, Walter H Gotlieb3. 1. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. 2. Department of Undergraduate Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. 3. Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: walter.gotlieb@mcgill.ca.
Abstract
OBJECTIVE: To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. METHODS: Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. RESULTS: All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. CONCLUSION: Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival.
OBJECTIVE: To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer. METHODS: Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery. RESULTS: All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years. CONCLUSION: Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival.
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