Impact of robotics on the outcome of elderly patients with endometrial cancer

• Robotic surgery in elderly patients with endometrial cancer decreases complication rates, blood transfusions, and hospital stay.
• No difference in 2-year disease-free survival was observed in elderly patients with endometrial cancer between open and robotic surgeries.

ObjectiveTo evaluate the impact of introducing a robotics program on clinical outcome of elderly patients with endometrial cancer.MethodsEvaluation and comparison of peri-operative morbidity and disease-free interval in 163 consecutive elderly patients (≥ 70 years) with endometrial cancer undergoing staging procedure with traditional open surgery compared to robotic surgery.ResultsAll consecutive patients ≥ 70 years of age with endometrial cancer who underwent robotic surgery (n = 113) were compared with all consecutive patients ≥ 70 years of age (n = 50) before the introduction of a robotic program in December 2007. Baseline patient characteristics were similar in both eras. Patients undergoing robotic surgery had longer mean operating times (244 compared with 217 minutes, p = 0.009) but fewer minor adverse events (17% compared with 60%, p < 0.001). The robotics cohort had less estimated mean blood loss (75 vs 334 mL, p < 0.0001) and shorter mean hospital stay (3 vs 6 days, p < 0.0001). There was no difference in disease-free survival (p = 0.61) during the mean follow-up time of 2 years.ConclusionTransitioning from open surgery to a robotics program for the treatment of endometrial cancer in the elderly has significant benefits, including lower minor complication rate, less operative blood loss and shorter hospitalization without compromising 2-year disease-free survival.