Robot-Assisted Management Of Endometrial Cancer In Belgium: An Analysis Of 615 Patients By The Belgian And Luxembourg Gynaecological Oncology Group

Introduction/Background The aim of this prospective study was to report perioperative outcomes, disease-free and overall survival of robot-assisted management of patients with endometrial cancer, treated in 5 centers in Belgium. Methodology Patients undergoing surgery between August 2007 and December 2018 (n=615) were prospectively collected. Results Median age was 68 years (range, 31–92), median BMI 28 kg/m2 (range, 17–61). Five-hundred-ninety-nine patients underwent robot-assisted hysterectomy and bilateral salpingo-oophorectomy. In addition, full pelvic lymphadenectomy was performed in 151 (25%), and pelvic sentinel nodes biopsies only in 181 patients (29%). Sixteen patients were referred for robotic node staging after hysterectomy performed elsewhere. Histological types were endometrioid (n=512, 84%), serous (n=43, 7%), clear cell (n=8, 1%), mucinous (n=3, 0.5%), squamous (n=2, 0.3%) and carcinosarcoma (n=20, 3%). FIGO stage was: IA (61%), IB (24%), II (4%), IIIA (2%), IIIB (0,3%), IIIC (8%), IV (1%). Metastatic pelvic nodes were found in 43 (7%), positive para-aortic nodes in 3 (0,4%), pelvic and para-aortic nodal metastases in 7 patients (1,2%). Median number of removed pelvic and para-aortic nodes was 15 (range, 0–64) and 10 (range 1–47), respectively. Median estimated blood loss was 50 mL (range 0– 1000), median skin-to-skin time 150 minutes (range 55–480) and conversion rate 0.8% (n=5). Intra-operative complications occurred in 5% (n=30). At least one postoperative complication occurred in 15% (n=89). Median follow-up was 27 months (range, 1–131). Recurrence occurred in 63 patients (11%) and 38 patients (6%) died of endometrial cancer. The 2- and 5-year recurrence-free survival rates were 89% and 84%, respectively. The 2- and 5-year overall survival rates were 92% and 83%, respectively. Conclusion This study confirms the feasibility and safety of robot-assisted management of endometrial cancer with a low complication, conversion and recurrence rate. Disclosure Nothing to disclose.