ObjectiveTo compare the safety and perioperative outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) vs laparoscopic RPLND (L-RPLND).
Patients and MethodsOur Institutional Review Board-approved retrospective testicular cancer registry was queried for patients who underwent a primary unilateral R-RPLND or L-RPLND by a single surgeon for a stage I testicular non-seminomatous germ cell tumour. Groups were compared for differences in baseline and outcome variables.
ResultsBetween July 2006 and July 2014, 16 R-RPLND and 21 L-RPLND cases were performed by a single surgeon. Intraand perioperative outcomes including operative time, estimated blood loss, lymph node yield, complicate rate, and ejaculatory status were similar between groups (all P > 0.1).
ConclusionsAs an early checkpoint, R-RPLND appears comparable to L-RPLND in terms of safety and perioperative outcomes. It remains unclear if R-RPLND offers any tangible benefits over standard laparoscopy.
Nonguideline directed care of patients with testicular cancer is common, most frequently in the form of inappropriate imaging and overtreatment. Nonguideline directed care leads to delayed definitive therapy, unnecessary morbidity and higher rates of relapse.
Objective
The incidence for uterine cancers has been reported to be higher among white women, whereas mortality is higher among black women. Reasons for the higher mortality among black women are not completely understood. The aim of our study is to examine the relationship between race/ethnicity, histopathologic subtype, and survival in uterine cancer.
Methods
We abstracted socio-demographic, treatment, and survival data for all women who were diagnosed with uterine cancer at Montefiore Medical Center from January 1999 through December 2009. Pathology records were reviewed.
Results
984 patients were identified. Racial/ethnic distribution was 382 (39%) white, 308 (31%) black, 232 (24%) Hispanic, and 62 (6.3%) other races, mixed, or unknown. 592 (60%) patients had endometrioid histology. Blacks were much more likely than whites to have non-endometrioid histologies (p<0.001), including papillary serous, carcinosarcoma, and leiomyosarcoma. Blacks and Hispanics were at least as likely as whites to receive either chemotherapy or radiation therapy. The hazard ratio for death for black versus white patients was 1.94 (p<0.001) when all histological subtypes were included. The hazard ratio for Hispanics for death was 1.2 (p=0.32) compared to whites. However, when patients were divided into endometrioid and non-endometrioid histological subtypes, there was no significant difference in survival by race/ethnicity.
Conclusion
Black patients with uterine cancer are much more likely to die and are much more likely to have non-endometrioid histologies than white patients. There are no differences in survival among white, black, or Hispanic women with uterine cancer, after control for histological subtype.
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