Outcomes of robotic surgery for endometrial cancer in elderly women
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. This is a retrospective comparative single-cen...
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| Veröffentlicht in: | Surgical oncology 2020-06, Vol.33, p.24-29 |
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| creator | Hotton, Judicael Koual, Meriem Gosset, Marie Rossi, Lea Delomenie, Myriam Ngo, Charlotte Lecuru, Fabrice Bats, Anne-Sophie |
| description | 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.
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.
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 |
| doi_str_mv | 10.1016/j.suronc.2019.12.010 |
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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.
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).
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.
•We compared the robotic management of endometrial cancer in patients ≥ 70 years and <70 years.•Elderly patients have more advanced and aggressive cancers.•They benefit from as much lymph node dissections despite more advanced stages.•Robot-assisted laparoscopy is feasible in elderly with similar complications rates.•There is no difference in survival.</description><identifier>ISSN: 0960-7404</identifier><identifier>EISSN: 1879-3320</identifier><identifier>DOI: 10.1016/j.suronc.2019.12.010</identifier><identifier>PMID: 32561088</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Abdominal surgery ; Age ; Age Factors ; Aged ; Aged, 80 and over ; Aorta ; Body mass index ; Cancer ; Cancer therapies ; Carcinoma, Endometrioid - surgery ; Chemotherapy ; Complications ; Conversion ; Dissection ; Elderly ; Endometrial cancer ; Endometrial neoplasm ; Endometrial Neoplasms - surgery ; Endometrium ; Feasibility ; Feasibility Studies ; Female ; Histology ; Hormone replacement therapy ; Humans ; Hypertension ; Hysterectomy ; Hysterectomy - methods ; Laparoscopy ; Laparotomy ; Life Sciences ; Lymph Node Excision ; Lymph nodes ; Lymphatic system ; Medical prognosis ; Middle Aged ; Morbidity ; Older people ; Oophorectomy ; Operative Time ; Progression-Free Survival ; Pulmonary embolisms ; Radiation therapy ; Robotic surgery ; Robotic Surgical Procedures - methods ; Robotic-assisted laparoscopy ; Robots ; Salpingo-oophorectomy - methods ; Sepsis ; Surgical outcomes ; Survival ; Treatment Outcome ; Tumors</subject><ispartof>Surgical oncology, 2020-06, Vol.33, p.24-29</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><rights>2020. Elsevier Ltd</rights><rights>Attribution - NonCommercial</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-e591b15163c07c191f6f76630dfd632e61dd9900a47be9a8dae867abc4709ec93</citedby><cites>FETCH-LOGICAL-c536t-e591b15163c07c191f6f76630dfd632e61dd9900a47be9a8dae867abc4709ec93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0960740419303858$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32561088$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03489896$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Hotton, Judicael</creatorcontrib><creatorcontrib>Koual, Meriem</creatorcontrib><creatorcontrib>Gosset, Marie</creatorcontrib><creatorcontrib>Rossi, Lea</creatorcontrib><creatorcontrib>Delomenie, Myriam</creatorcontrib><creatorcontrib>Ngo, Charlotte</creatorcontrib><creatorcontrib>Lecuru, Fabrice</creatorcontrib><creatorcontrib>Bats, Anne-Sophie</creatorcontrib><title>Outcomes of robotic surgery for endometrial cancer in elderly women</title><title>Surgical oncology</title><addtitle>Surg Oncol</addtitle><description>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.
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.
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).
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.
•We compared the robotic management of endometrial cancer in patients ≥ 70 years and <70 years.•Elderly patients have more advanced and aggressive cancers.•They benefit from as much lymph node dissections despite more advanced stages.•Robot-assisted laparoscopy is feasible in elderly with similar complications rates.•There is no difference in survival.</description><subject>Abdominal surgery</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aorta</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Carcinoma, Endometrioid - surgery</subject><subject>Chemotherapy</subject><subject>Complications</subject><subject>Conversion</subject><subject>Dissection</subject><subject>Elderly</subject><subject>Endometrial cancer</subject><subject>Endometrial neoplasm</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Endometrium</subject><subject>Feasibility</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Histology</subject><subject>Hormone replacement therapy</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hysterectomy</subject><subject>Hysterectomy - methods</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Life Sciences</subject><subject>Lymph Node Excision</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Older people</subject><subject>Oophorectomy</subject><subject>Operative Time</subject><subject>Progression-Free Survival</subject><subject>Pulmonary embolisms</subject><subject>Radiation therapy</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotic-assisted laparoscopy</subject><subject>Robots</subject><subject>Salpingo-oophorectomy - methods</subject><subject>Sepsis</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0960-7404</issn><issn>1879-3320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFv1DAQhS0EapfSf4BQJC7tIWHGTpz4glStWoq0Ui9wthx7Al5l42InRfvv8SqlBw6cRvJ882b8HmPvESoElJ_2VVpimGzFAVWFvAKEV2yDXatKITi8ZhtQEsq2hvqcvU1pDwCy5XjGzgVvJELXbdj2YZltOFAqwlDE0IfZ2yIL_6B4LIYQC5pcbs_Rm7GwZrIUCz8VNDqK47H4nXvTO_ZmMGOiy-d6wb7f3X7b3pe7hy9ftze70jZCziU1CntsUAoLrUWFgxxaKQW4wUnBSaJzSgGYuu1Jmc4Z6mRrelu3oMgqccGuV92fZtSP0R9MPOpgvL6_2enTG4i6U52ST5jZq5V9jOHXQmnWB58sjaOZKCxJ8xobrgSvu4x-_AfdhyVO-SeZykapk42ZqlfKxpBSpOHlAgR9CkTv9RqIPgWikescSB778Cy-9AdyL0N_E8jA5xWg7NyTp6iT9ZR9dj6SnbUL_v8b_gCVDZxV</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Hotton, Judicael</creator><creator>Koual, Meriem</creator><creator>Gosset, Marie</creator><creator>Rossi, Lea</creator><creator>Delomenie, Myriam</creator><creator>Ngo, Charlotte</creator><creator>Lecuru, Fabrice</creator><creator>Bats, Anne-Sophie</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><general>Elsevier</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope></search><sort><creationdate>20200601</creationdate><title>Outcomes of robotic surgery for endometrial cancer in elderly women</title><author>Hotton, Judicael ; Koual, Meriem ; Gosset, Marie ; Rossi, Lea ; Delomenie, Myriam ; Ngo, Charlotte ; Lecuru, Fabrice ; Bats, Anne-Sophie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-e591b15163c07c191f6f76630dfd632e61dd9900a47be9a8dae867abc4709ec93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal surgery</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aorta</topic><topic>Body mass index</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Carcinoma, Endometrioid - surgery</topic><topic>Chemotherapy</topic><topic>Complications</topic><topic>Conversion</topic><topic>Dissection</topic><topic>Elderly</topic><topic>Endometrial cancer</topic><topic>Endometrial neoplasm</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Endometrium</topic><topic>Feasibility</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Histology</topic><topic>Hormone replacement therapy</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hysterectomy</topic><topic>Hysterectomy - methods</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Life Sciences</topic><topic>Lymph Node Excision</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Older people</topic><topic>Oophorectomy</topic><topic>Operative Time</topic><topic>Progression-Free Survival</topic><topic>Pulmonary embolisms</topic><topic>Radiation therapy</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotic-assisted laparoscopy</topic><topic>Robots</topic><topic>Salpingo-oophorectomy - methods</topic><topic>Sepsis</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hotton, Judicael</creatorcontrib><creatorcontrib>Koual, Meriem</creatorcontrib><creatorcontrib>Gosset, Marie</creatorcontrib><creatorcontrib>Rossi, Lea</creatorcontrib><creatorcontrib>Delomenie, Myriam</creatorcontrib><creatorcontrib>Ngo, Charlotte</creatorcontrib><creatorcontrib>Lecuru, Fabrice</creatorcontrib><creatorcontrib>Bats, Anne-Sophie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>Surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hotton, Judicael</au><au>Koual, Meriem</au><au>Gosset, Marie</au><au>Rossi, Lea</au><au>Delomenie, Myriam</au><au>Ngo, Charlotte</au><au>Lecuru, Fabrice</au><au>Bats, Anne-Sophie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of robotic surgery for endometrial cancer in elderly women</atitle><jtitle>Surgical oncology</jtitle><addtitle>Surg Oncol</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>33</volume><spage>24</spage><epage>29</epage><pages>24-29</pages><issn>0960-7404</issn><eissn>1879-3320</eissn><abstract>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.
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.
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).
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.
•We compared the robotic management of endometrial cancer in patients ≥ 70 years and <70 years.•Elderly patients have more advanced and aggressive cancers.•They benefit from as much lymph node dissections despite more advanced stages.•Robot-assisted laparoscopy is feasible in elderly with similar complications rates.•There is no difference in survival.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32561088</pmid><doi>10.1016/j.suronc.2019.12.010</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdominal surgery Age Age Factors Aged Aged, 80 and over Aorta Body mass index Cancer Cancer therapies Carcinoma, Endometrioid - surgery Chemotherapy Complications Conversion Dissection Elderly Endometrial cancer Endometrial neoplasm Endometrial Neoplasms - surgery Endometrium Feasibility Feasibility Studies Female Histology Hormone replacement therapy Humans Hypertension Hysterectomy Hysterectomy - methods Laparoscopy Laparotomy Life Sciences Lymph Node Excision Lymph nodes Lymphatic system Medical prognosis Middle Aged Morbidity Older people Oophorectomy Operative Time Progression-Free Survival Pulmonary embolisms Radiation therapy Robotic surgery Robotic Surgical Procedures - methods Robotic-assisted laparoscopy Robots Salpingo-oophorectomy - methods Sepsis Surgical outcomes Survival Treatment Outcome Tumors |
| title | Outcomes of robotic surgery for endometrial cancer in elderly women |
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