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KMID : 1137020230340060068
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Journal of Gynecologic Oncology
2023 Volume.34 No. 6 p.68 ~ p.68
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Efficacy and prognosis of robotic surgery with sentinel node navigation surgery in endometrial cancer
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Shinichi Togami
Mika Fukuda
Mika Mizuno
Shintaro Yanazume
Hiroaki Kobayashi
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Abstract
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Objective : This study aimed to validate the surgical and oncologic outcomes of robotic surgery with sentinel node navigation surgery (SNNS) in endometrial cancer.
Methods : This study included 130 patients with endometrial cancer, who underwent robotic surgery, including hysterectomy, bilateral salpingo-oophorectomy, and pelvic SNNS at the Department of Obstetrics and Gynecology of Kagoshima University Hospital. Pelvic sentinel lymph nodes (SLNs) were identified using the uterine cervix 99m Technetium-labeled phytate and indocyanine green injections. Surgery-related and survival outcomes were also evaluated.
Results : The median operative and console times and volume of blood loss were 204 (range: 101?555) minutes, 152 (range: 70?453) minutes, and 20 (range: 2?620) mL, respectively. The bilateral and unilateral pelvic SLN detection rates were 90.0% (117/130) and 5.4% (7/130), respectively, and the identification rate (the rate at which at least one SLN could be identified on either side) was 95% (124/130). Lower extremity lymphedema occurred in only 1 patient (0.8%), and no pelvic lymphocele occurred. Recurrence occurred in 3 patients (2.3%), and the recurrence site was the abdominal cavity, with dissemination in 2 patients and vaginal stump in one. The 3-year recurrence-free survival and 3-year overall survival rates were 97.1% and 98.9%, respectively.
Conclusion : Robotic surgery with SNNS for endometrial cancer showed a high SLN identification rate, low occurrence rates of lower extremity lymphedema and pelvic lymphocele, and excellent oncologic outcomes.
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KEYWORD
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Endometrial Cancer, Prognosis, Surgery, Sentinel Lymph Node, Lymph Nodes
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