Pernille Tine Jensen

Survival after a nationwide introduction of robotic surgery in women with early-stage endometrial cancer: a population-based prospective cohort study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Siv Lykke Jørgensen, Department of Gynaecology and Obstetrics, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, B. Winsløws Vej 9 A, 5000 Odense C, Denmark; Department of Clinical Health, Faculty of Health Sciences, Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense C, Denmark. Electronic address: siv.lykke.joergensen@rsyd.dk.
  • ,
  • Ole Mogensen
  • Chunsen S Wu
  • Malene Korsholm, Department of Gynaecology and Obstetrics, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, B. Winsløws Vej 9 A, 5000 Odense C, Denmark; Department of Clinical Health, Faculty of Health Sciences, Clinical Institute, University of Southern Denmark, J.B. Winsløws Vej 19, 5000 Odense C, Denmark; Danish Centre for Health Economics (DaCHE), Department of Public Health, University of Southern Denmark, J.B. Winsløws
  • ,
  • Ken Lund, Centre for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, 5000 Odense, Denmark; Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000 Odense C, Denmark. Electronic address: Ken.lund@rsyd.dk.
  • ,
  • Pernille T Jensen

PURPOSE: The purpose of the study was to evaluate the association between a nationwide introduction of robotic minimally invasive surgery (RMIS) and survival in women with early-stage endometrial cancer.

MATERIALS AND METHODS: Prospective data on consecutive women with early-stage endometrial cancer who underwent surgery during January 2005 to June 2015 in Denmark were identified in the nationwide Danish Gynaecological Cancer Database. Data were linked with national registries regarding comorbidity, education, income and death. The cohort was divided according to the time they underwent surgery: Group 1 before RMIS introduction in their respective region and Group 2 after RMIS introduction. Five-year overall survival was compared by multivariate Cox proportional hazards models stratified by histopathological risk between Groups 1 and 2 and between surgical modalities within Group 2: total abdominal hysterectomy (TAH), laparoscopic minimally invasive surgery (LMIS) and RMIS.

RESULTS: Women in Group 1 (N = 3091) had significantly lower overall survival compared with those in Group 2 (N = 2563; hazard ratio [HR], 1.22; 95% confidence interval [CI], 1.05-1.42). Age, smoking, socioeconomic status, American Society of Anaesthesiologists (ASA) score, comorbidity and histopathological risk influenced the overall survival. Following RMIS adoption, TAH was associated with higher mortality compared with LMIS and RMIS (HR, 1.42; 95% CI 1.02-1.97 and HR, 1.70; 95% CI 1.31-2.19 for LMIS and RMIS, respectively). There was no significant survival difference between RMIS and LMIS (HR, 1.19; 95% CI 0.85-1.68).

CONCLUSION: The national introduction of robotic surgery for early-stage endometrial cancer was associated with improved survival irrespective of age, body mass index, ASA score, comorbidity, smoking, socioeconomic status and histopathological risk.

OriginalsprogEngelsk
TidsskriftEuropean journal of cancer (Oxford, England : 1990)
Vol/bind109
Sider (fra-til)1-11
Antal sider11
ISSN0959-8049
DOI
StatusUdgivet - mar. 2019
Eksternt udgivetJa

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