Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Roma, Italy.
Università Cattolica del Sacro Cuore, Roma, Italy.
J Gynecol Oncol. 2021 May;32(3):e45. doi: 10.3802/jgo.2021.32.e45.
The aim of this study is to analyze and draw the potential differences between the robotic-assisted surgery (RS) and the laparoscopy (LPS) in endometrial cancer staging.
In this single-institution retrospective study we enrolled 1,221 consecutive clinical stage I-III endometrial cancer patients undergone minimally invasive surgical staging. We compared patients treated by LPS and by RS, on the basis of perioperative and oncological outcomes (disease-free survival [DFS] and overall survival [OS]). A sub-analysis of the high-risk endometrial cancer population was performed in the 2 cohorts.
The 2 cohorts (766 treated by LPS and 455 by RS) were homogeneous in terms of perioperative and pathological data. We recorded differences in number of relapse/progression (11.7% in LPS vs. 7% in RS, p=0.008) and in number of deaths (9.8% in LPS vs. 4.8% in RS, p=0.002). Whereas, univariate and multivariate analyses according to DFS and OS confirmed that the surgical approach did not influence the DFS or the OS. In the multivariable analysis the association of the age and grading was significant for DFS and OS. In the sub-analysis of the 426 high risk EC patients (280 in LPS and 146 in RS) the univariate and the multivariate confirmed the influence of the age in DFS and OS, independently of the minimally invasive approach.
In our large retrospective analysis, we confirmed that the RS and LPS have similar efficacy and safety for endometrial cancer staging also for the high-risk endometrial cancer patients.
本研究旨在分析和比较机器人辅助手术（RS）与腹腔镜手术（LPS）在子宫内膜癌分期中的潜在差异。
本单中心回顾性研究纳入了 1221 例接受微创外科分期的临床 I-III 期子宫内膜癌患者。我们比较了接受 LPS 和 RS 治疗的患者，基于围手术期和肿瘤学结果（无病生存率[DFS]和总生存率[OS]）。对 2 组高危子宫内膜癌患者进行了亚分析。
2 组（766 例接受 LPS 治疗，455 例接受 RS 治疗）在围手术期和病理数据方面具有可比性。我们记录了复发/进展的数量存在差异（LPS 组为 11.7%，RS 组为 7%，p=0.008）和死亡数量存在差异（LPS 组为 9.8%，RS 组为 4.8%，p=0.002）。然而，根据 DFS 和 OS 的单因素和多因素分析证实，手术方法并不影响 DFS 或 OS。在多变量分析中，年龄和分级的组合对 DFS 和 OS 有显著影响。在高危子宫内膜癌患者（280 例在 LPS 组，146 例在 RS 组）的亚分析中，单因素和多因素分析均证实，年龄对 DFS 和 OS 有影响，与微创手术方法无关。
在我们的大型回顾性分析中，我们证实 RS 和 LPS 在子宫内膜癌分期方面具有相似的疗效和安全性，也适用于高危子宫内膜癌患者。
