Impact of robotics on the outcome of elderly patients with endometrial cancer.
OBJECTIVE
To evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer.


METHODS
Evaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥70years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery.


RESULTS
All consecutive patients ≥70years of age with endometrial cancer who underwent robotic surgery (n=113) were compared with all consecutive patients ≥70years of age (n=50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217minutes, p=0.009) but fewer minor adverse events (17% compared with 60%, p<0.001). The robotics cohort had less estimated mean blood loss (75 vs 334mL, p<0.0001) and shorter mean hospital stay (3 vs 6days, p<0.0001). There was no difference in disease-free survival (p=0.61) during the mean follow-up time of 2years.


CONCLUSIONS
Transitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival.
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Vincent
V
Lavoue
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Xing
X
Zeng
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Susie
S
Lau
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Joshua Z
JZ
Press
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Jeremie
J
Abitbol
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Raphael
R
Gotlieb
Department of Undergraduate Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Jeffrey
J
How
Department of Undergraduate Medical Education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Yifan
Y
Wang
Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: walter.gotlieb@mcgill.ca.
Walter H
WH
Gotlieb
D000230:Adenocarcinoma / Q000601:surgery*; D018262:Adenocarcinoma, Clear Cell / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D018196:Carcinoma, Adenosquamous / Q000601:surgery*; D018269:Carcinoma, Endometrioid / Q000601:surgery; D002296:Carcinosarcoma / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision / Q000379:methods*; D061646:Operative Time; D011183:Postoperative Complications; D012371:Robotics; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
Elderly; Endometrial cancer; Morbidity; Open surgery; Robotic surgery; Survival