To compare clinical and pathologic features, surgical morbidity, and outcomes stratified by age in patients with endometrial cancer who underwent Robotic-assisted laparoscopic total hysterectomy (RALTH) vs. Total Abdominal Hysterectomy
All women with surgically treated endometrial cancer at the Newark Beth Israel Medical Center between January 2004 and December 2015 were eligible; 353 patients met criteria and underwent retrospective chart review. Patients were stratified into 3 groups based on age the ranges <45, 46-64 and >65 years. Demographic data, pathologic, surgical treatment and complications were retrospectively reviewed. Statistical analysis was performed by SPSS.
There were no statistically significant differences regarding operation characteristics and complications in patients with age <45 years. In patients of age between 46-64 years, there was a statistically significant increased estimated blood loss (EBL), median (range), (400 (50-6000) cc vs. 100 (20-7000) cc, p: <0.001) and length of stay (LOS) 4 (1-51) vs. 1.5 (1-41) days, p: <0.001 in the TAH group compared to the RALTH group. Patients who underwent RALTH experienced longer operative time than the TAH group (234.3±81.2 vs. 259.5±68.4, p:0.039). In patients with age >65 years, LOS [7 (2-39) vs. 2 (1-43) days, p<0.001] and intra-operative hemorrhage [14/79 (17.7%) vs. 1/78 (1.2%), p<0.001] were significantly higher in TAH than the RALTH patients.
Older patients with endometrial cancer benefit from the lower rate of postoperative complications with RALTH than TAH. Patients undergoing RALTH benefit from decreased postoperative morbidity.