Analysis of disease recurrence and survival for women with uterine malignancies undergoing robotic surgery
| Autor: | Robert W. Holloway, Glenn E. Bigsby, Xiang Zhu, Sarfraz Ahmad, Lorna A. Brudie, Floor J. Backes, David M. O'Malley, Neil J. Finkler, David E. Cohn, Jeffrey M. Fowler |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Brachytherapy Hysterectomy Disease-Free Survival Young Adult Risk Factors medicine Humans Robotic surgery Lymph node Survival analysis Aged Neoplasm Staging Retrospective Studies Chemotherapy business.industry Medical record Endometrial cancer Obstetrics and Gynecology Robotics Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Oncology Uterine Neoplasms Lymph Node Excision Female Lymphadenectomy Neoplasm Recurrence Local business |
| Zdroj: | Gynecologic Oncology. 128:309-315 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2012.11.005 |
| Popis: | Objectives To evaluate recurrence-free survival (RFS) and overall survival (OS) for patients who underwent robotic-assisted laparoscopic hysterectomy (RALH) for uterine malignancies. Methods Medical records from 372 patients with uterine malignancies who underwent RALH from 3/06 to 3/09 at two institutions were reviewed for clinico-pathologic data, adjuvant therapies, disease recurrence, and survival. Median follow-up for survival analysis was 31±14months. Thirty (8.1%) patients were lost to follow-up before 12months and censored from the recurrence analysis. Results Mean age and BMI of 372 patients was 61.8±9.8years and 32.2±8.4kg/m 2 (range 19–70). Robotic procedures included RALH 16 (4.3%), RALH with pelvic lymphadenectomy (PL) 96 (25.8%), and RALH with pelvic-and-aortic lymphadenectomy (PAL) 252 (67.7%) cases. Histology included 319 (85.8%) endometrioid and 53 (12.6%) high-risk histologies. Mean pelvic and aortic lymph node counts were 16.8±8.7 and 8.4±4.5, respectively. Lymph node metastases were identified in 26 (7.3%) cases. Adjuvant therapies were prescribed for 108 (29.1%) of patients: 7.8% brachytherapy, 1.9% pelvic radiation+brachytherapy, 7.8% chemotherapy, 11.6% chemotherapy+radiation. Risk of recurrence for all patients was 8.3% and 17 (4.6%) patients died of disease. The estimated 3-year recurrence-free survival (RFS) for the entire study group was 89.3% and the estimated 5-year overall survival (OS) was 89.1%, compared to 92.5% and 93.4% for the endometrioid sub-set. Conclusions Patients with endometrial cancer undergoing robotic hysterectomy with staging lymphadenectomies during our 3-years of robotic experience had low-risk for recurrence and excellent disease-specific survival at a median follow-up time of 31months. |
| Databáze: | OpenAIRE |
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