Comparing oncologic outcomes after minimally invasive and open surgery for pediatric neuroblastoma and Wilms tumor

A rapid progression from conventional open surgery to minimally invasive approaches in the surgical management of colorectal cancer has occurred over the last 2 decades. Initial concerns that this new approach was oncologically inferior to open surgery were ultimately refuted when several prospective randomized trials concluded that laparoscopic colectomy could achieve similar oncologic outcomes to open surgery. On the contrary, level 1 data has not yet matured regarding the oncologic safety of minimally invasive approaches for rectal cancer. We review the published literature pertaining to the evolution of minimally invasive techniques used to treat colorectal cancer surgery, including barriers to adoption, and the prospects for future advances related to innovative techniques.

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Comparison of minimally invasive versus open surgery in the treatment of endometrial carcinosarcoma

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001573 ◽

2020 ◽

Vol 30 (8) ◽

pp. 1162-1168

Author(s):

Silvana Pedra Nobre ◽

Jennifer J. Mueller ◽

Ginger J. Gardner ◽

Kara Long Roche ◽

Carol L Brown ◽

...

Keyword(s):

Minimally Invasive ◽

Hospital Stay ◽

Open Surgery ◽

Survival Rates ◽

Length Of Hospital Stay ◽

Open Group ◽

Oncologic Outcomes ◽

Preoperative Imaging ◽

Open Approach ◽

Invasive Group

ObjectiveThe aim of this study was to compare perioperative and oncologic outcomes between minimally invasive and open surgery in the treatment of endometrial carcinosarcoma.MethodsWe retrospectively identified all patients with newly diagnosed endometrial carcinosarcoma who underwent primary surgery via any approach at our institution from January 2009 to January 2018. Patients with known bulky disease identified on preoperative imaging were excluded. The χ2 and Mann–Whitney U tests were used to compare categorical and continuous variables, respectively. Kaplan–Meier curves were used to estimate survival, and compared using the log rank test.ResultsWe identified 147 eligible patients, of whom 37 (25%) underwent an open approach and 110 (75%) underwent minimally invasive surgery. Within the minimally invasive group, 92 (84%) of 110 patients underwent a robotic procedure and 14 (13%) underwent a laparoscopic procedure. Four minimally invasive cases (4%) were converted to open procedures. Median age, body mass index, operative time, stage, complication grade, and use of adjuvant treatment were clinically and statistically similar between groups. Median length of hospital stay in the open group was 4 days (range 3–21) compared with 1 day (range 0–6) in the minimally invasive group (p<0.001). The rates of any 30-day complication were 46% in the open and 8% in the minimally invasive group (p<0.001). The rates of grade 3 or higher complications were 5.4% and 1.8%, respectively (p=0.53). Median follow-up for the entire cohort was 30 months (range 0.4–121). Two-year progression-free survival rates were 52.8% (SE±8.4) in the open group and 58.5% (SE±5.1) in the minimally invasive group (p=0.7). Two-year disease-specific survival rates were 66.1% (SE±8.0) and 81.4% (SE±4.1), respectively (p=0.8).ConclusionsIn patients with clinical stage I endometrial carcinosarcoma, minimally invasive compared with open surgery was not associated with poor oncologic outcomes, but with a shorter length of hospital stay and a lower rate of overall complications.

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Trends in Oncology: an Updated Review of Minimally Invasive Surgery vs. Traditional Open Surgery

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2020-0032 ◽

2020 ◽

Vol 5 (4) ◽

pp. 129-136

Author(s):

Kyuwon Lee ◽

Ahromi Wang

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Open Surgery ◽

Patient Characteristics ◽

Oncologic Outcomes ◽

Cochrane Library ◽

Surgical Methods ◽

Acceptable Method ◽

Recent Trends

AbstractObjective: To review the recent trends in methodology for the most frequent oncological surgeries. More specifically, this paper will compare the minimally invasive methods to the conventional open method. It aims to find out whether minimally invasive surgeries are feasible treatments for certain types of cancers.Methods: A review of retrospective studies searched in PubMed, Cochrane Library etc. was used to identify the studies published on this topic within a period of 6 years. Oncologic outcomes, postoperative complications/outcomes, and intraoperative outcomes were the main variables in the comparison to the surgical methods under review.Conclusion: Despite the recent controversy with minimally invasive surgery being contraindicated for cervical cancer, it is still an acceptable method for other types of common cancers. However, there are limitations to the approach, and the surgeon should make a prudent selection between minimally invasive and open surgery depending on the type of tumor and patient characteristics. Further studies, especially with randomized control trials, must be conducted.

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Minimally Invasive Approach for Wilms Tumor Treatment in a Small Child - A Case Report

Urology ◽

10.1016/j.urology.2020.12.003 ◽

2020 ◽

Author(s):

Alexandre Azevedo Ziomkowski ◽

João Rafael Silva Simões Estrela ◽

Nilo Jorge Carvalho Leão Barretto ◽

Nilo César Leão Barretto

Keyword(s):

Case Report ◽

Minimally Invasive ◽

Wilms Tumor ◽

Small Child ◽

Tumor Treatment ◽

Minimally Invasive Approach ◽

Invasive Approach

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Faculty Opinions recommendation of Minimally invasive surgery versus open surgery for the treatment of solid abdominal and thoracic neoplasms in children.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13996966.15453073 ◽

2012 ◽

Author(s):

Neyssa Marina

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Open Surgery ◽

Thoracic Neoplasms

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Faculty Opinions recommendation of Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718001594.793478386 ◽

2013 ◽

Author(s):

Sabine Tejpar ◽

Loredana Vecchione

Keyword(s):

Rectal Cancer ◽

Randomized Controlled Trials ◽

Open Surgery ◽

Pooled Analysis ◽

Oncologic Outcomes ◽

Controlled Trials ◽

Randomized Controlled

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Survival in endometrial cancer in relation to minimally invasive surgery or open surgery – a Swedish Gynecologic Cancer Group (SweGCG) study

BMC Cancer ◽

10.1186/s12885-021-08289-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Christer Borgfeldt ◽

Erik Holmberg ◽

Janusz Marcickiewicz ◽

Karin Stålberg ◽

Bengt Tholander ◽

...

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Endometrial Cancer ◽

Minimally Invasive ◽

Cancer Patients ◽

Surgical Approach ◽

Open Surgery ◽

Gynecologic Cancer ◽

Multivariable Analysis ◽

Figo Stage

Abstract Background The aim of this study was to analyze overall survival in endometrial cancer patients’ FIGO stages I-III in relation to surgical approach; minimally invasive (MIS) or open surgery (laparotomy). Methods A population-based retrospective study of 7275 endometrial cancer patients included in the Swedish Quality Registry for Gynecologic Cancer diagnosed from 2010 to 2018. Cox proportional hazard models were used in univariable and multivariable survival analyses. Results In univariable analysis open surgery was associated with worse overall survival compared with MIS hazard ratio, HR, 1.39 (95% CI 1.18–1.63) while in the multivariable analysis, surgical approach (MIS vs open surgery) was not associated with overall survival after adjustment for known risk factors (HR 1.12, 95% CI 0.95–1.32). Higher FIGO stage, non-endometrioid histology, non-diploid tumors, lymphovascular space invasion and increasing age were independent risk factors for overall survival. Conclusion The minimal invasive or open surgical approach did not show any impact on survival for patients with endometrial cancer stages I-III when known prognostic risk factors were included in the multivariable analyses.

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