Vaginal hysterectomy and abdominal hysterectomy for treatment of endometrial cancer in the elderly

Susini, Tommaso; Massi, Giambattista; Amunni, Gianni; Carriero, Carlo; Marchionni, M; Taddei, Gianluigi; Scarselli, Gianfranco

doi:10.1016/j.ygyno.2004.10.005

Cited by 58 publications

(24 citation statements)

References 14 publications

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“…With regards to endometrial cancer, there is no consensus on the optimal surgical approach (minimally invasive, laparotomy, vaginal) for [3,4,16,17]. Thus, elderly patients may not receive the same surgical standard of care as their younger counterparts.…”

Section: Discussionmentioning

confidence: 99%

“…This could be due to concerns of increased morbidity and mortality of therapy and surgeon/patient preference, [3,4,16,17]. Modification of therapy (vaginal hysterectomy, omitting nodal dissection based on age and/ or physician preference) due to these concerns has been recently reported in the literature [4,16]. However, are these concerns well justified and what impact does surgical approach have on morbidity and mortality in the elderly with endometrial cancer?…”

Section: Discussionmentioning

confidence: 99%

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Robotic surgical management of endometrial cancer in octogenarians and nonagenarians: analysis of perioperative outcomes and review of the literature

et al. 2010

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The primary aim of this article is to report the outcomes of octogenarians and nonagenarians who have undergone robotic surgery for endometrial cancer. A multi-institutional research consortium was created to evaluate the utility of robotics for gynecologic surgery (benign and malignant). IRB approval was obtained at each institution. A multi-institutional HIPPA compliant database was then created and analyzed for all patients that underwent robotic-assisted surgery with staging for endometrial cancer between the April 2003 and January 2009. In total, 395 patients were identified. A subset of patients between the ages of 80 and 95 years were then identified and analyzed for demographic data and perioperative outcomes. Twenty-seven patients in this age group were identified who underwent robotic-assisted hysterectomy and staging. The median age was 84, and median body mass index was 28. Comorbidities such as diabetes mellitus and hypertension were identified in 22 and 74% of patients, respectively. Over one-half (56%) of the patients reported a prior abdominal surgery. Final pathological analysis demonstrated that 88% of all patients had either Stage I or II disease. The median operative time was 192 min. The median estimated blood loss was 50 cc, and the median lymph node count was 16. The median hospital stay was 1.0 day. The overall intraoperative and postoperative complication rate was 7.4 and 33%, respectively. No patient received a blood transfusion. There was one conversion to laparotomy (3.7%). A comparison of the outcomes of the elderly cohort to those of all patients in the database (control group) revealed that there was no statistically significant difference between the groups in terms of operative time, blood loss, hospital stay, nodal yield, or conversion rate. Intraoperative complications were statistically similar between the groups; however, postoperative complications were significantly higher in the elderly cohort. We conclude that robotic surgery is safe, feasible, and expands surgical options for octogenarians and nonagenarians diagnosed with endometrial cancer. Age should not be considered a contraindication for robotic surgical management of patients with endometrial cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Robotic surgical management of endometrial cancer in octogenarians and nonagenarians: analysis of perioperative outcomes and review of the literature

et al. 2010

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“…In 1997, Knocke (21). Another recent study in early-stage endometrial cancer by Susini showed a 10-year DSS rate of 84% with abdominal hysterectomy in Stage I disease (22).…”

Section: Discussionmentioning

confidence: 99%

The management of inoperable Stage I endometrial cancer using intracavitary brachytherapy alone: A 20-year institutional review

et al. 2009

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“…Wenn keine Lymphadenektomie vorgesehen ist, sehen Chan et al und Susini et al nach Abwägung aller Vor-und Nachteile auch eine vaginale Hysterektomie mit bilateraler Adnexektomie als gleichwertig an [14] [15]. Die kürzere Operationszeit, ein signifikant geringerer Blutverlust und ein vergleichbares 5-und 10-Jahres-Überleben zeigen in diesen Studien einen deutlichen Vorteil gegenüber dem abdominalen Zugangsweg.…”

Section: Figo Iunclassified

Operative Therapie des Endometriumkarzinoms

et al. 2007

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Vaginal hysterectomy and abdominal hysterectomy for treatment of endometrial cancer in the elderly

Cited by 58 publications

References 14 publications

Robotic surgical management of endometrial cancer in octogenarians and nonagenarians: analysis of perioperative outcomes and review of the literature

Robotic surgical management of endometrial cancer in octogenarians and nonagenarians: analysis of perioperative outcomes and review of the literature

The management of inoperable Stage I endometrial cancer using intracavitary brachytherapy alone: A 20-year institutional review

Operative Therapie des Endometriumkarzinoms

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