John K Chan1, Austin B Gardner2, Katie Taylor3, Kevin Blansit4, Caroline A Thompson2, Rebecca Brooks5, Xinhua Yu6, Daniel S Kapp7. 1. Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA. Electronic address: chanjohn@sutterhealth.org. 2. Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA. 3. Division of Gynecologic Oncology, California Pacific Palo Alto Medical Foundation, San Francisco, CA, USA. 4. Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA. 5. Division of Gynecologic Oncology, University Of California, San Francisco, San Francisco, CA, USA. 6. Department of Epidemiology and Biostatistics, University of Memphis, Memphis, TN, USA. 7. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.
Abstract
OBJECTIVE: To evaluate the hospital and patient factors associated with robotic surgery for endometrial cancer in the United States. METHODS: Data was obtained from the Nationwide Inpatient Sample from the year 2010. Chi-squared and multivariate analyses were used for statistical analysis. RESULTS: Of the 6560 endometrial cancer patients who underwent surgery, the median age was 62 (range: 22 to 99). 1647 (25%) underwent robotic surgery, 820 (13%) laparoscopic, and 4093 (62%) had open surgery. The majority was White (65%). Hospitals with 76 or more hysterectomy cases for endometrial cancer patients per year (4% of hospitals in the study) performed 31% of all hysterectomies and 40% of all robotic hysterectomies (p<0.01). 29% of Whites had robotic surgery compared to 15% of Hispanics, 12% of Blacks, and 11% of Asians (p<0.01). Patients with upper-middle and high incomes underwent robotic surgery more than patients with low or middle incomes (p<0.01). 27% of Medicare patients and 26% of patients with private insurance had robotic surgery compared to only 14% of Medicaid patients and 12% of uninsured patients (p<0.01). CONCLUSIONS: The majority of robotic surgeries for endometrial cancer were performed at a small number of high-volume hospitals in the United States. Socioeconomic status, insurance type, and race were also important predictors for the use of RS. Further studies are warranted to better understand the barriers to receiving minimally invasive surgery.
OBJECTIVE: To evaluate the hospital and patient factors associated with robotic surgery for endometrial cancer in the United States. METHODS: Data was obtained from the Nationwide Inpatient Sample from the year 2010. Chi-squared and multivariate analyses were used for statistical analysis. RESULTS: Of the 6560 endometrial cancerpatients who underwent surgery, the median age was 62 (range: 22 to 99). 1647 (25%) underwent robotic surgery, 820 (13%) laparoscopic, and 4093 (62%) had open surgery. The majority was White (65%). Hospitals with 76 or more hysterectomy cases for endometrial cancerpatients per year (4% of hospitals in the study) performed 31% of all hysterectomies and 40% of all robotic hysterectomies (p<0.01). 29% of Whites had robotic surgery compared to 15% of Hispanics, 12% of Blacks, and 11% of Asians (p<0.01). Patients with upper-middle and high incomes underwent robotic surgery more than patients with low or middle incomes (p<0.01). 27% of Medicare patients and 26% of patients with private insurance had robotic surgery compared to only 14% of Medicaid patients and 12% of uninsured patients (p<0.01). CONCLUSIONS: The majority of robotic surgeries for endometrial cancer were performed at a small number of high-volume hospitals in the United States. Socioeconomic status, insurance type, and race were also important predictors for the use of RS. Further studies are warranted to better understand the barriers to receiving minimally invasive surgery.
Authors: Amin Sanei-Moghaddam; Chaeryon Kang; Robert P Edwards; Paula J Lounder; Naveed Ismail; Sharon L Goughnour; Suketu M Mansuria; John T Comerci; Faina Linkov Journal: J Racial Ethn Health Disparities Date: 2017-08-24
Authors: Ravi Rajaram; Sanjay Mohanty; David J Bentrem; Emily S Pavey; David D Odell; Ankit Bharat; Karl Y Bilimoria; Malcolm M DeCamp Journal: Ann Thorac Surg Date: 2017-01-18 Impact factor: 4.330
Authors: Maria B Schiavone; Maciej S Bielen; Ginger J Gardner; Oliver Zivanovic; Elizabeth L Jewell; Yukio Sonoda; Richard R Barakat; Dennis S Chi; Nadeem R Abu-Rustum; Mario M Leitao Journal: Gynecol Oncol Date: 2016-01-08 Impact factor: 5.482
Authors: Antti A Mäkitie; Harri Keski-Säntti; Mari Markkanen-Leppänen; Leif Bäck; Petri Koivunen; Tomas Ekberg; Karl Sandström; Göran Laurell; Mathias von Beckerath; Johan S Nilsson; Peter Wahlberg; Lennart Greiff; Lena Norberg Spaak; Thomas Kjærgaard; Christian Godballe; Oddveig Rikardsen; Hani Ibrahim Channir; Niclas Rubek; Christian von Buchwald Journal: Front Oncol Date: 2018-07-27 Impact factor: 6.244