Prognosis of positive peritoneal cytology in minimally invasive surgery for early-stage endometrial cancer

ObjectiveTo investigate the prevalence of positive peritoneal cytology and lymph-vascular invasion by surgical approach among patients with early stage endometrioid endometrial carcinoma undergoing hysterectomy.MethodsThe National Cancer Database was accessed and patients with FIGO stage I endometrioid endometrial carcinoma (with no history of another tumor diagnosed) who underwent simple hysterectomy (open or minimally invasive) between January 2010 and December 2015 and had available data on the presence of lymph-vascular invasion and/or status of peritoneal cytology were selected for further analysis. The impact of a surgical approach on the odds of lymph-vascular invasion and positive peritoneal cytology was calculated after controlling for tumor grade, size, and depth of myometrial invasion.ResultsA total of 74 732 patients who met the inclusion criteria were identified. The rate of minimally invasive hysterectomy was 75.7%. Data on peritoneal cytology status and lymph-vascular invasion were available for 50 185 and 71 641 patients, respectively. A higher proportion of patients who had minimally invasive hysterectomy had positive peritoneal cytology (4.4% vs 2.3%, p<0.001), and presence of lymph-vascular invasion (10.4% vs 9.2%, p<0.001). After controlling for tumor size, tumor grade, and disease substage, the performance of minimally invasive surgery was associated with higher odds of positive peritoneal cytology (OR 2.08, 95% CI 1.83 to 2.37) and presence of lymph-vascular invasion (OR 1.33, 95% CI 1.25 to 1.41). After controlling for confounders there was no difference in survival between open and minimally invasive surgery groups (HR 0.93, 95% CI 0.85 to 1.004).ConclusionsMinimally invasive surgery may be associated with a higher incidence of positive peritoneal cytology and lymph-vascular invasion among patients with early stage endometrioid endometrial cancer. There was no difference in overall survival between patients who had laparotomy or minimally invasive surgery.

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EP541 Nationwide introduction of robotic minimally invasive surgery was associated with improved survival and decreased odds of severe complications in women with early-stage endometrial cancer: a population-based prospective cohort study

10.1136/ijgc-2019-esgo.598 ◽

2019 ◽

Author(s):

S Joergensen ◽

O Mogensen ◽

CS Wu ◽

K Lund ◽

M Iachina ◽

...

Keyword(s):

Endometrial Cancer ◽

Cohort Study ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Prospective Cohort Study ◽

Invasive Surgery ◽

Prospective Cohort ◽

Early Stage ◽

Population Based ◽

Early Stage Endometrial Cancer

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Perspectives of Gynecologic Oncologists on Minimally Invasive Surgery During COVID-19 Pandemic: A Turkish Society of Minimally Invasive Gynecologic Oncology (MIJOD) Survey

10.21203/rs.3.rs-491643/v1 ◽

2021 ◽

Author(s):

nasuh utku dogan ◽

Esra Bilir ◽

Salih Taskin ◽

Dogan Vatansever ◽

Selen Dogan ◽

...

Keyword(s):

Endometrial Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Early Stage ◽

Gynecologic Oncology ◽

University Hospital ◽

Neo Adjuvant Chemotherapy ◽

Turkish Society ◽

Early Stage Endometrial Cancer

Abstract Study ObjectiveTo evaluate gynecologic oncologists’ trends and attitudes towards the use of Minimally invasive surgery (MIS) in active period of the COVID-19 pandemic in Turkey.DesignOnline national survey sent to members of Turkish Endoscopy Platform consisting of six sections and 45 questions between the dates 1-15 June 2020 in Turkey to explore their surgical practice during the pandemic. SettingThree hospital types: Education and research hospital/university hospital, state hospital and private HospitalParticipantsGynecologic oncologists who are members of Turkish Endoscopy PlatformMeasurements and Results58 % of participants canceled all operations except for cancer surgeries and emergent operations. About a quarter of participants (28%) continued to operate laparoscopically and/or robotically. For the evaluation of the suspected adnexial mass (SAM) 64% used laparotomy and only 13 % operated by laparoscopy (L/S). For the management of low-risk early-stage endometrial cancer only fifth of the participants preferred to perform L/S. For endometrial cancer with high-intermediate risk factors more than half of participants preferred complete staging with laparotomy. For advanced stage ovarian cancer, one-fifth of the participants preferred to perform an explorative laparotomy, whilst 15 % preferred diagnostic laparoscopy to triage the patients for either NACT or cytoreductive surgery. On the contrary 41 % of participants chose to have cytology by paracentesis for neo-adjuvant chemotherapy (NACT). Gynecologic oncologists with >10 years L/S experience used MIS more for SAM. Furthermore, experienced surgeons used L/S more for endometrial cancer patients. In busy COVID hospitals, more participants preferred laparotomy over L/S. ConclusionUse of MIS decreased during the pandemic in Turkey. More experienced surgeons continued to perform MIS. Surgical treatment was the preferred approach for SAM, early-stage endometrial cancer. However, NACT was more popular compared to radical surgery.

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