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Abstract
Introduction In the era of sentinel lymph node mapping, the clinical outcomes between laparotomic, laparoscopic and robotic surgeries were infrequently reported. Herein, we aimed to compare the clinical outcomes between the above surgical groups.
Methods All consecutive women who received surgical treatment between January 2008 and May 2021 were reviewed from medical records. Only women with clinically determined uterine-confined disease based on preoperative physical examination and radiological survey were included. Chi-square test and Fisher’s exact test were used as appropriate. Survival curves were generated using the Kaplan-Meier method, and the statistical differences in the survival curves were estimated with the log-rank test.
Results A total of 334 cases were reviewed. Baseline characteristics were similar, despite a higher rate of sentinel lymph node mapping in the laparoscopy group (5% - laparotomy vs. 42% - laparoscopy vs. 21% - robot, p<0.001, table 1). The total number of dissected lymph nodes was higher in the laparotomic group, compared with the laparoscopic and robotic groups (p<0.0001, table 1); however, the positive lymph node rate did not differ between groups (8.6% - laparotomy vs. 3.8% - laparoscopy vs. 11.9% - robot, p=0.15, table 1). The recurrence-free survival and overall survival also did not differ between groups (log-rank test, p=0.85 and 0.50, respectively, figures 1 and 2).
Comparison of baseline data and clinical outcomes between the laparotomy, laparoscopy and robot groups in women with clinically uterine-confined endometrial cancer (n=334)
Recurrence free survival
Overall survival
Conclusion/Implications Less numbers of lymph nodes were dissected in the laparoscopy and robot groups, compared with laparotomy. However, recurrence-free survival and overall survival seem similar between the laparotomy, laparoscopy and robot surgical groups in women with uterine-confined endometrial cancer.