Introduction/Background Surgical treatment is the cornerstone for women with early-stage endometrial cancer, which has been seen an increasing incidence in Taiwan. Minimally invasive surgery (MIS) is associated with less complications, little is known for the comparison of open and MIS approaches in Taiwan. Preliminary results are reported here.

Methodology We used the Taiwan Cancer Registry (TWCR), which is a nationwide and population-based database, to collect data. Between 2018 and 2020, women with early-stage endometrial cancer who underwent staging surgery and had pathological diagnosis were included. The main outcome measure is harvested lymph node number (LNH).

Results A total of 5567 patients were included in this analysis (1696 in 2018, 1982 in 2019, 1889 in 2020, respectively). Median age was 56 years. 93.30% of patients had stage I disease and 6.70% had stage II. The endometrioid subtype accounted for 84.98% of all patients. Overall, 3057 (54.91%) underwent open surgery for hysterectomy and staging. 36.29% and 8.80% patients received laparoscopic surgery (LS) or robotic surgery (RS), respectively. Adoption of LS and RS were 37.80% and 7.83% in 2020, respectively, compared to 33.55% and 10.79% in 2018. 46.52% of stage I patients underwent MIS, compared to 25.20% for stage II. Conversion to open surgery occurred to 0.36% of patients. Sentinel LN sampling (SLS) was performed in 3.59% patients. The mean number of LNH was 20.89 (± 14.16) for open surgery, 21.84 (± 16.54) for RS, and 16.59 (± 12.56) for LS, respectively (P<0.0001). In stage I disease, the mean number of LNH was 20.58 (± 14.07) for open, 21.67 (± 16.56) for RS, and 16.50 (± 12.55) for LS, respectively.

Conclusion Open surgery remains the majority in Taiwan. RS achieved comparable LN harvest as open surgery. SLS was performed in 3.59% of patients. RS could serve as an alternative MIS approach for endometrial cancer.

Disclosures The study was supported by Intuitive.