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- Title
Trends and outcomes of minimally invasive surgery for endometrial cancer in Kanagawa academic institutions: a retrospective observational study.
- Authors
Jun Takeuchi; Hiroko Machida; Shinichi Endo; Kazuyoshi Kato; Taichi Mizushima; Estuko Miyagi; Takashi Mastuo; Nao Suzuki; Mikio Mikami
- Abstract
Objective: Despite the increase of minimally invasive hysterectomy for endometrial cancer in Japan, comprehensive data on the role of minimally invasive surgery (MIS) including robot-assisted surgery remain limited. We examined the use of MIS and recurrence in hysterectomy for endometrial cancer within academic institutions in Kanagawa. Methods: A retrospective observational study was conducted using data from four academic institutions in Kanagawa spanning the period from 2018 to 2022. The study assessed the trends and predictors of MIS usage in initial endometrial cancer treatment, comparing it with abdominal surgery. Additionally, the study examined the profile of robot-assisted procedures. Results: Out of 1,146 patients, 517 (45.1%) underwent minimally invasive hysterectomy, while 629 (54.9%) opted for abdominal hysterectomy during the study period. The proportion of MIS procedures substantially increased from 18.3% to 60.9% (p<0.001). Multivariable analysis revealed that patients undergoing MIS were more likely to be enrolled in recent years, exhibit stage I disease, have less myometrial invasion, and were less inclined to undergo lymphadenectomy (all adjusted p<0.05). Furthermore, the performance of robot-assisted procedures surged from 0.6% in 2018 to 18.7% in 2022 (annual percent change 90.1%, 95% confidence interval=49.5-141.7, p=0.003). Patients undergoing robot-assisted procedures were more likely to be enrolled in recent years, possess obesity (body mass index ≥25), and have stage I disease (all adjusted p<0.05). During the study, the 2-year recurrence rate remained at a median of 10.5% (±0.9 standard deviation). Conclusion: MIS has increased significantly in recent years, accounting for nearly 60% of surgical management of endometrial cancer in Kanagawa. MIS does not appear to compromise short-term recurrence.
- Subjects
KANAGAWA-ken (Japan); MINIMALLY invasive procedures; ENDOMETRIAL cancer; ENDOMETRIAL surgery; ABDOMINAL surgery; ONCOLOGIC surgery; SURGICAL robots
- Publication
Journal of Gynecologic Oncology, 2024, Vol 35, p19
- ISSN
2005-0380
- Publication type
Article
- DOI
10.3802/jgo.2024.35.S2.O8