title: A population-based registry study evaluating surgery in newly diagnosed uterine cancer.
abstract: BACKGROUND
  The aim was to evaluate surgical treatment of newly diagnosed uterine cancer in a Swedish population.
  
  
  METHODS
  Data in the GynOp registry from 2008 to 2014 were analyzed.
  
  
  RESULTS
  In total, 3443 cases were included: 430 (12%) were robotic-assisted laparoscopic, 272 (8%) laparoscopic, and 2741 (80%) abdominal operations. There was an increasing trend in minimally invasive surgery from 2008 to 2014 (41%). Women with lymph nodes removed in the robotic-assisted laparoscopic group experienced less blood loss (mean 105 vs. 377 mL), shorter length of hospital stay (2.4 vs. 4.1 days), and fewer days to normal activities of daily living (6.5 vs. 12.7 days) (all p < 0.001) compared with the abdominal group, but operating time did not differ. Similar results were found in women with no lymph node removal and in women with body mass index ≥35. Major complications during hospital stay, reoperations, and time to work were less in both minimally invasive groups. More lymph nodes were retrieved in the abdominal (mean 34.4) than in the robotic-assisted laparoscopic (mean 26.0) group, but the number of women with lymph node metastases did not differ, totaling 211/960 (21.9%; 95% CI 19.4-24.7%). Isolated para-aortic lymph node metastases were found in 3.9% (95% CI 2.4-5.6%) of women.
  
  
  CONCLUSIONS
  Minimally invasive surgery in uterine cancer patients reduces days to normal activities of daily living, number of days to return to work, length of hospital stay, and blood loss in patients without and with lymph node dissection and in obese patients.
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Christer
authors.identifier: http://orcid.org/0000-0003-2267-8325
authors.initials: C
authors.lastname: Borgfeldt
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Grigorios
authors.identifier: http://orcid.org/0000-0003-1657-7704
authors.initials: G
authors.lastname: Kalapotharakos
authors.affiliation: Department of Obstetrics & Gynecology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Katrin C
authors.initials: KC
authors.lastname: Asciutto
authors.affiliation: Department of Obstetrics & Gynecology, Umeå University Hospital, Umeå University, Umeå, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Löfgren
authors.affiliation: Department of Cancer Epidemiology, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Högberg
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000639:trends; D010535:Laparoscopy / Q000706:statistics & numerical data / Q000639:trends; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D016015:Logistic Models; D008197:Lymph Node Excision / Q000706:statistics & numerical data / Q000639:trends; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D020127:Recovery of Function; D012042:Registries; D062707:Return to Work / Q000706:statistics & numerical data; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data / Q000639:trends; D013548:Sweden; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000601:surgery*
keywords: Cancer; hysterectomy; laparoscopy; lymphadenectomy; obesity; surgical techniques; training