Christer Borgfeldt1, Grigorios Kalapotharakos1, Katrin C Asciutto1, Mats Löfgren2, Thomas Högberg3. 1. Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden. 2. Department of Obstetrics & Gynecology, Umeå University Hospital, Umeå University, Umeå, Sweden. 3. Department of Cancer Epidemiology, Skåne University Hospital, Lund University, Lund, Sweden.
Abstract
INTRODUCTION: The aim was to evaluate surgical treatment of newly diagnosed uterine cancer in a Swedish population. MATERIAL AND METHODS: Data in the GynOp registry from 2008 to 2014 were analyzed. RESULTS: In total, 3443 cases were included: 430 (12%) were robotic-assisted laparoscopic, 272 (8%) laparoscopic, and 2741 (80%) abdominal operations. There was an increasing trend in minimally invasive surgery from 2008 to 2014 (41%). Women with lymph nodes removed in the robotic-assisted laparoscopic group experienced less blood loss (mean 105 vs. 377 mL), shorter length of hospital stay (2.4 vs. 4.1 days), and fewer days to normal activities of daily living (6.5 vs. 12.7 days) (all p < 0.001) compared with the abdominal group, but operating time did not differ. Similar results were found in women with no lymph node removal and in women with body mass index ≥35. Major complications during hospital stay, reoperations, and time to work were less in both minimally invasive groups. More lymph nodes were retrieved in the abdominal (mean 34.4) than in the robotic-assisted laparoscopic (mean 26.0) group, but the number of women with lymph node metastases did not differ, totaling 211/960 (21.9%; 95% CI 19.4-24.7%). Isolated para-aortic lymph node metastases were found in 3.9% (95% CI 2.4-5.6%) of women. CONCLUSIONS: Minimally invasive surgery in uterine cancer patients reduces days to normal activities of daily living, number of days to return to work, length of hospital stay, and blood loss in patients without and with lymph node dissection and in obese patients.
INTRODUCTION: The aim was to evaluate surgical treatment of newly diagnosed uterine cancer in a Swedish population. MATERIAL AND METHODS: Data in the GynOp registry from 2008 to 2014 were analyzed. RESULTS: In total, 3443 cases were included: 430 (12%) were robotic-assisted laparoscopic, 272 (8%) laparoscopic, and 2741 (80%) abdominal operations. There was an increasing trend in minimally invasive surgery from 2008 to 2014 (41%). Women with lymph nodes removed in the robotic-assisted laparoscopic group experienced less blood loss (mean 105 vs. 377 mL), shorter length of hospital stay (2.4 vs. 4.1 days), and fewer days to normal activities of daily living (6.5 vs. 12.7 days) (all p < 0.001) compared with the abdominal group, but operating time did not differ. Similar results were found in women with no lymph node removal and in women with body mass index ≥35. Major complications during hospital stay, reoperations, and time to work were less in both minimally invasive groups. More lymph nodes were retrieved in the abdominal (mean 34.4) than in the robotic-assisted laparoscopic (mean 26.0) group, but the number of women with lymph node metastases did not differ, totaling 211/960 (21.9%; 95% CI 19.4-24.7%). Isolated para-aortic lymph node metastases were found in 3.9% (95% CI 2.4-5.6%) of women. CONCLUSIONS: Minimally invasive surgery in uterine cancerpatients reduces days to normal activities of daily living, number of days to return to work, length of hospital stay, and blood loss in patients without and with lymph node dissection and in obesepatients.
Authors: Christer Borgfeldt; Erik Holmberg; Janusz Marcickiewicz; Karin Stålberg; Bengt Tholander; Elisabeth Åvall Lundqvist; Angelique Flöter-Rådestad; Maria Bjurberg; Pernilla Dahm-Kähler; Kristina Hellman; Elisabet Hjerpe; Preben Kjölhede; Per Rosenberg; Thomas Högberg Journal: BMC Cancer Date: 2021-06-02 Impact factor: 4.430