Robot Assisted Comprehensive Surgical Staging for Endometrial Cancer: A Validation Study

*Corresponding author: Nitin A. Wadhwa*, Dennis Mauricio, Isabel Eisner, Ruchi K. Wadhwa and Pankaj Singhal

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original research

Abstract

Objective

The study sought to evaluate the historical surgical-pathological trends in Gynecologic Oncology Group (GOG) 33 in a cohort of patients who underwent robot-assisted staging of uterine carcinomas.

Materials and Methods

This is a retrospective study from June 2016 through December 2018 at Catholic Health Services Hospitals in Long Island (CHSLI), NY, USA. All patients underwent robotic surgical staging with hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy. Fifty patients were included, and patients were separated into cohorts with endometrioid or non-endometrioid histology for analysis. Patients were staged using the International Federation of Gynecology and Obstetrics (FIGO) 2009 classification.

Results

For all patients undergoing surgical staging, the rate of pelvic and para-aortic nodal metastases occurred at 10% and 8%, respectively. Sixty percent of the grade 1 endometrioid tumors had less than 50% myometrial invasion. No patients had positive paraaortic lymph nodes in the absence of pelvic node involvement. High-risk histologies were associated with nodal disease thirteen percent of the time. A correlation between increasing depth of invasion and positive lymph nodes was demonstrated. Increasing grade of tumors was correlated with the frequency of nodal metastasis. Intraperitoneal spread was highly correlated to metastatic lymph nodes. Deep invasion was positively correlated with nodal disease.

Conclusion

The results of this study validate the trends previously known from GOG 33 in a population undergoing robot-assisted surgical staging for uterine carcinomas.

Keywords

Gynecologic Oncology Group (GOG) 33; Robotic; Surgery; Uterine cancer; Lymph nodes; Trends.