Comparison of laparoscopic and robotic-assisted minimally invasive surgery with sentinel lymph node navigation in low-risk endometrial cancer: a retrospective analysis.

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Shinichi Togami, Nozomi Furuzono, Mika Mizuno, Hiroaki Kobayashi
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引用次数: 0

Abstract

Objective: To evaluate and compare the perioperative and oncologic outcomes of laparoscopic and robotic-assisted surgeries in patients with low-risk endometrial cancer who underwent minimally invasive surgery (MIS) for complete surgical staging, including sentinel lymph node mapping.

Methods: A retrospective study included 190 patients diagnosed with low-risk endometrial cancer who underwent MIS combined with sentinel lymph node navigation surgery (SNNS) between December 2016 and December 2021. Among these patients, 66 underwent laparoscopic surgery, while 124 underwent robotic-assisted surgery. The analysis focused on patient characteristics, perioperative outcomes, and prognostic factors, including recurrence-free survival (RFS) and overall survival (OS). Statistical analysis was performed using Kaplan-Meier survival curves and appropriate comparative tests for outcome evaluation.

Results: The median operative time and estimated blood loss were significantly longer and greater in the robotic surgery group than in the laparoscopic group (209.5 vs. 157.5 min, 20 vs. 5 mL, respectively). The identification rates of sentinel nodes were 97% and 95.2% in the laparoscopic and robotic groups, respectively, with no significant difference between the 2. Recurrence was observed in two and three cases in the laparoscopic robotic surgery groups, respectively. The 3-year RFS rates were 97.6% (95% confidence interval [CI]=0.8482-0.9769) and 93.9% (95% CI=0.9277-0.9922) for the robotic and laparoscopic groups, respectively, while the 3-year OS rates were 99.2% (95% CI=0.8561-0.9902) and 96.1% (95% CI=0.9450-0.9989), respectively, with no statistically significant differences.

Conclusion: MIS combined with SNNS is a highly effective approach for managing low-risk endometrial cancer, providing comparable oncologic outcomes to laparoscopy while enhancing the quality of life of patients.

腹腔镜和机器人辅助微创手术前哨淋巴结导航治疗低风险子宫内膜癌的比较:回顾性分析。
目的:评估和比较低危子宫内膜癌患者行微创手术(MIS)完成手术分期(包括前哨淋巴结作图)的腹腔镜和机器人辅助手术的围手术期和肿瘤预后。方法:一项回顾性研究纳入了2016年12月至2021年12月期间接受MIS联合前哨淋巴结导航手术(SNNS)的190例低风险子宫内膜癌患者。在这些患者中,66人接受了腹腔镜手术,124人接受了机器人辅助手术。分析的重点是患者特征、围手术期结局和预后因素,包括无复发生存期(RFS)和总生存期(OS)。采用Kaplan-Meier生存曲线和适当的比较试验进行统计分析。结果:机器人手术组的中位手术时间和估计失血量明显大于腹腔镜手术组(分别为209.5 vs 157.5 min, 20 vs 5 mL)。腹腔镜组和机器人组前哨淋巴结的检出率分别为97%和95.2%,两者之间差异无统计学意义。在腹腔镜机器人手术组中分别有2例和3例复发。机器人组和腹腔镜组的3年RFS率分别为97.6%(95%可信区间[CI]=0.8482-0.9769)和93.9% (95% CI= 0.9270 -0.9922), 3年OS率分别为99.2% (95% CI=0.8561-0.9902)和96.1% (95% CI=0.9450-0.9989),差异无统计学意义。结论:MIS联合SNNS是治疗低风险子宫内膜癌的一种非常有效的方法,可提供与腹腔镜相当的肿瘤预后,同时提高患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Gynecologic Oncology
Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.00
自引率
2.60%
发文量
84
审稿时长
>12 weeks
期刊介绍: The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.
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