Robotic Surgery: Changing the Surgical Approach for Endometrial Cancer in a Referral Cancer Center

Peiretti, Michele; Zanagnolo, Vanna; Bocciolone, Luca; Landoni, Fabio; Colombo, Nicoletta; Minig, Lucas; Sanguineti, F.; Maggioni, Angelo

doi:10.1016/j.jmig.2009.03.013

Cited by 53 publications

(29 citation statements)

References 15 publications

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“…Remarkable advances have occurred in innovative medical technologies and therapies for patients with cancer 5 such as targeted chemotherapy, 104 robotic surgery, 105 and positron imaging tomography/positron emission tomography scans for radio-imaging. 106 However, psychosocial therapies have not witnessed the same advancement in scientific support and technological delivery.…”

Section: Future Directions For Oncology Research and Practicementioning

confidence: 99%

Psychosocial Therapies for Patients With Cancer

et al. 2013

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Background. As part of a new standard of quality cancer care, the Institute of Medicine has recommended inclusion of therapies that address psychosocial needs of cancer patients. A range of psychosocial therapies for managing acute and chronic stress have been developed for patients with cancer, based on the scientific framework of psychoneuroimmunology (PNI). The current review aimed to identify studies of new and emerging PNI-based psychosocial therapies in patients with cancer that have used neuroendocrine-immune biomarkers as outcomes. Specifically, this review aimed to evaluate studies based on the cancer populations involved, types of psychosocial therapies, and PNI measures employed. Methods. Methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The PubMed, EMBASE, PsychINFO, CINAHL, and Google Scholar online databases were searched using combinations of keywords obtained from previous reviews of psychosocial interventions. Studies from 2001 to 2012 were included if they (a) were published in English, (b) used experimental or quasi-experimental designs, (c) evaluated psychosocial therapies, (d) involved cancer patients, and (e) reported results on at least one neuroendocrine or immune outcome measure. The search strategy identified 403 records and 2 stages of screening were used to eliminate irrelevant studies. Results. A total of 24 cancer-specific studies of psychosocial therapies that used PNI-based outcome measures were included in this review. Most studies included early-stage breast cancer patients, and 2 major types of therapies emerged, cognitive-behavioral therapies and complementary medical therapies. Durations of interventions ranged widely, from 1.3 hours over a single week to 27 hours over 18 weeks. Considerable diversity in PNI outcomes made statistical comparisons problematic. Studies of cognitive-behavioral therapies were found to have reported the most success in impacting PNI-based measures, which were typically functional measures of the immune system, for example, cytokines. Conclusions. Several issues related to research methodology are discussed. Most important, studies examining dose-response associations and resource allocation are needed to guide future research. A standardized panel of psychosocial instruments and biomarkers for PNIbased studies would enhance comparability of findings across studies when evaluating this body of research and assist with integrating psychosocial therapies into the standard of cancer care.

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Section: Future Directions For Oncology Research and Practicementioning

confidence: 99%

Psychosocial Therapies for Patients With Cancer

et al. 2013

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“…From [1], copyright CDC particular in cases with complex gynecological procedures. The disadvantages of robotic-assisted surgery are the absence of tactile feedback, the large size of robotic equipment, the lack of vaginal access, larger skin incisions for inserting trocars, and the higher costs and learning curve [15,16].…”

Section: Laparoscopically Assisted Vaginal Hysterectomy and Total Lapmentioning

confidence: 99%

Current therapy of patients with endometrial carcinoma

Marnitz

Köhler

2011

Strahlenther Onkol

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Magnetic resonance imaging (MRI), 18-FDG positron emission tomography ((18)FDG PET-CT), and computed tomography (CT) have demonstrated disappointing detectability of lymph node metastases in endometrial cancer. The treatment of choice in patients with endometrial cancer is hysterectomy and bilateral salpingoophorectomy. Above all, obese patients with comorbidity have benefited the most from laparoscopically assisted approaches. For inoperable patients in FIGO stage I/II, radiation remains an alternative to hysterectomy. The role of pelvic and paraaortic lymphadenectomy is the most controversial issue in endometrial carcinoma treatment. The current spectrum of treatment ranges from no lymphadenectomy, exclusive pelvic or additional inframesentric paraaortic sampling, or complete pelvic to infrarenal paraaortic lymphadenectomy. The sentinel concept in patients with endometrial carcinoma is far from being introduced into routine clinical practice. Without a lymphadenectomy, decision making for adjuvant therapy remains a challenge, because no information is available from lymph node status and the reliability of pathologic grading is poor. For patients after hysterectomy with a low risk of local relapse (stage I/II without additional risk factors), vaginal brachytherapy is sufficient to prevent vaginal relapses. Adjuvant external beam irradiation (EBRT) in stage I/II demonstrated improved local control which impacted overall survival only in patients with high-risk features (higher age, grading myometrial infiltration). Stage IIIC patients seem to benefit from EBRT with regard to overall survival. In patients at high risk of progression (grade 3, MI > 50%, FIGO IIIC, unfavorable histology), multimodal treatment should be considered. The optimal substances and sequences are under investigation.

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“…Boggess et al 16 conducted a case-control study of robot assisted laparoscopic radical hysterectomy compared with laparotomic approach, and this study showed that robot assisted laparoscopic radical hysterectomy is superior to open radical hysterectomy with regard to blood loss, operative time, hospital stay, and lymph 10 Magrina et al 14 Boggess et al 16 Fanning et al 15 Estape et al 13 Persson et al 11 Lowe et al 12 Maggioni et al 18 Boggess et al 19 DeNardis et al 20 Seamon et al 24 Veljovich et al 25 Peiretti et al 22 Lowe et al As many researchers demonstrated the feasibility of robotic radical hysterectomy in cervical cancer, several authors showed that the robot assisted staging surgery in endometrial cancer is comparable to conventional laparoscopic and laparotomic approach in terms of surgical outcomes. [19][20][21][22][23][24][25][26] In addition, length of hospital stay, blood loss and peri-operative complication rates are significantly lower in patients who received robotic surgery than those who underwent laparotomic staging surgery. Comparing with laparoscopic staging, the advantages of robot assisted laparoscopic staging surgery are somewhat distinct in obese patients with regard to surgical outcomes.…”

Section: Robot Assisted Laparoscopic Surgery In Gynecologic Cancermentioning

confidence: 99%

Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology

Jung

Kim

2009

J Gynecol Oncol

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Two innovative approaches in minimally invasive surgery that have been introduced recently are the da Vinci robotic platform and single port laparoscopic surgery (SPLS). Robotic surgery has many advantages such as 3-dimensional view, the wrist like motion of the robotic arm and ergonomically comfortable position for the surgeon. Numerous literatures have demonstrated the feasibility of robotic surgery in gynecologic oncology. However, further research should be performed to demonstrate the superiority of robotic surgery compared to conventional laparoscopy. Additionally, cost reduction of robotic surgery is needed to adopt robotic surgery into gynecologic oncology worldwide. SPLS has several possible benefits including reduced operative complications, reduced postoperative pain, and better cosmetic results compared to conventional laparoscopy. Although several authors have indicated that SPLS is a feasible approach for gynecologic surgery, there have been few reports demonstrating the potential advantages over conventional laparoscopy. Moreover, technical difficulties of SPLS still exist. Therefore, the advantages of a single port approach compared to conventional laparoscope should be evaluated with comparative study, and further technologic development for SPLS is also needed. These two progressive technologies take the lead in the development of MIS and further studies should be performed to evaluate the benefits of robot surgery and SPLS.

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Robotic Surgery: Changing the Surgical Approach for Endometrial Cancer in a Referral Cancer Center

Cited by 53 publications

References 15 publications

Psychosocial Therapies for Patients With Cancer

Psychosocial Therapies for Patients With Cancer

Current therapy of patients with endometrial carcinoma

Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology

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