Judicael Hotton1, Meriem Koual2, Marie Gosset2, Lea Rossi2, Myriam Delomenie3, Charlotte Ngo4, Fabrice Lecuru2, Anne-Sophie Bats5. 1. Department of Surgical Oncology, Lorraine Cancer Institute, Vandoeuvre-les-Nancy, France and Faculty of Medicine, Lorraine University, Nancy, France. 2. Department of Gynecologic Oncologic Surgery, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Faculty of Medicine, Paris-Descartes University, Paris, France. 3. Department of Gynecologic Oncologic Surgery, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France. 4. Department of Gynecologic Oncologic Surgery, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Faculty of Medicine, Paris-Descartes University, Paris, France; INSERM UMR-S1124, Paris Descartes University, Paris, France. 5. Department of Gynecologic Oncologic Surgery, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Faculty of Medicine, Paris-Descartes University, Paris, France; INSERM UMR-S1124, Paris Descartes University, Paris, France. Electronic address: anne-sophie.bats@aphp.fr.
Abstract
INTRODUCTION: Few data have been reported on robot-assisted surgery in elderly. The objectives were to compare feasibility, complication data, and survival of patients under and upper the age of 70 who are managed for endometrial cancer by robot-assisted laparoscopy. MATERIALS AND METHODS: This is a retrospective comparative single-center study including patients treated between January 2007 and December 2016. Patients were divided into 2 groups: less than 70 years and greater than or equal to 70 years. The primary endpoint was the rate of complications. The secondary endpoints were conversion rate and follow-up. RESULTS: 148 patients were included: 86 under 70 (group A) and 62 aged 70 and over (group B). More adhesiolysis was performed in group B (p < .01); the pelvic and para-aortic lymph node dissection rates were not different between both groups (p = .2 and p = .9). The operating times were significantly longer in group B (220.1 vs. 234.4 min, p = .02). The conversion rate was similar between the 2 groups (p = .7). The tumors were endometrioid adenocarcinomas for 77.9 and 66.7% respectively (p = .2), with grade 3 tumors more represented in older patients (24.4% vs. 48.4%, p < .01). There were more tumors at high risk of recurrence after 70 years (33.7 vs. 45.2%, p = .04). No significant difference was found for postoperative complications. There was no difference in overall survival (p = .7) or progression-free survival (p = .2). Undertreated women rate was similar in both groups (p = .1). CONCLUSION: Robotic surgery appears feasible and reproducible and could bring a benefit and allow optimal surgery without increasing the morbidity in the management of endometrial cancers whatever the age is.
INTRODUCTION: Few data have been reported on robot-assisted surgery in elderly. The objectives were to compare feasibility, complication data, and survival of patients under and upper the age of 70 who are managed for endometrial cancer by robot-assisted laparoscopy. MATERIALS AND METHODS: This is a retrospective comparative single-center study including patients treated between January 2007 and December 2016. Patients were divided into 2 groups: less than 70 years and greater than or equal to 70 years. The primary endpoint was the rate of complications. The secondary endpoints were conversion rate and follow-up. RESULTS: 148 patients were included: 86 under 70 (group A) and 62 aged 70 and over (group B). More adhesiolysis was performed in group B (p < .01); the pelvic and para-aortic lymph node dissection rates were not different between both groups (p = .2 and p = .9). The operating times were significantly longer in group B (220.1 vs. 234.4 min, p = .02). The conversion rate was similar between the 2 groups (p = .7). The tumors were endometrioid adenocarcinomas for 77.9 and 66.7% respectively (p = .2), with grade 3 tumors more represented in older patients (24.4% vs. 48.4%, p < .01). There were more tumors at high risk of recurrence after 70 years (33.7 vs. 45.2%, p = .04). No significant difference was found for postoperative complications. There was no difference in overall survival (p = .7) or progression-free survival (p = .2). Undertreated women rate was similar in both groups (p = .1). CONCLUSION: Robotic surgery appears feasible and reproducible and could bring a benefit and allow optimal surgery without increasing the morbidity in the management of endometrial cancers whatever the age is.