TY - JOUR
T1 - Minimally invasive surgery for endometrial cancer
T2 - Does operative start time impact surgical and oncologic outcomes?
AU - Slaughter, Katrina N.
AU - Frumovitz, Michael
AU - Schmeler, Kathleen M.
AU - Nick, Alpa M.
AU - Fleming, Nicole D.
AU - Reis, Ricardo Dos
AU - Munsell, Mark F.
AU - Westin, Shannon N.
AU - Soliman, Pamela T.
AU - Ramirez, Pedro T.
N1 - Funding Information:
Supported in part by the Cancer Center Support Grant (NCI Grant P30 CA016672 ).
PY - 2014/8
Y1 - 2014/8
N2 - Objective Recent literature in ovarian cancer suggests differences in surgical outcomes depending on operative start time. We sought to examine the effects of operative start time on surgical outcomes for patients undergoing minimally invasive surgery for endometrial cancer. Methods A retrospective review was conducted of patients undergoing minimally invasive surgery for endometrial cancer at a single institution between 2000 and 2011. Surgical and oncologic outcomes were compared between patients with an operative start time before noon and those with a surgical start time after noon. Results A total of 380 patients were included in the study (245 with start times before noon and 135 with start times after noon). There was no difference in age (p = 0.57), number of prior surgeries (p = 0.28), medical comorbidities (p = 0.19), or surgical complexity of the case (p = 0.43). Patients with surgery starting before noon had lower median BMI than those beginning after noon, 31.2 vs. 35.3 respectively (p = 0.01). No significant differences were observed for intraoperative complications (4.4% of patients after noon vs. 3.7% of patients before noon, p = 0.79), estimated blood loss (median 100 cc vs. 100 cc, p = 0.75), blood transfusion rates (7.4% vs. 8.2%, p = 0.85), and conversion to laparotomy (12.6% vs. 7.4%, p = 0.10). There was no difference in operative times between the two groups (198 min vs. 216.5 min, p = 0.10). There was no association between operative start time and postoperative non-infectious complications (11.9% vs. 11.0%, p = 0.87), or postoperative infections (17.8% vs. 12.3%, p = 0.78). Length of hospital stay was longer for surgeries starting after noon (median 2 days vs. 1 day, p = 0.005). No differences were observed in rates of cancer recurrence (12.6% vs. 8.8%, p = 0.39), recurrence-free survival (p = 0.97), or overall survival (p = 0.94). Conclusion Our results indicate equivalent surgical outcomes and no increased risk of postoperative complications regardless of operative start time in minimally invasive endometrial cancer staging, despite longer length of hospital stay for surgeries beginning after noon.
AB - Objective Recent literature in ovarian cancer suggests differences in surgical outcomes depending on operative start time. We sought to examine the effects of operative start time on surgical outcomes for patients undergoing minimally invasive surgery for endometrial cancer. Methods A retrospective review was conducted of patients undergoing minimally invasive surgery for endometrial cancer at a single institution between 2000 and 2011. Surgical and oncologic outcomes were compared between patients with an operative start time before noon and those with a surgical start time after noon. Results A total of 380 patients were included in the study (245 with start times before noon and 135 with start times after noon). There was no difference in age (p = 0.57), number of prior surgeries (p = 0.28), medical comorbidities (p = 0.19), or surgical complexity of the case (p = 0.43). Patients with surgery starting before noon had lower median BMI than those beginning after noon, 31.2 vs. 35.3 respectively (p = 0.01). No significant differences were observed for intraoperative complications (4.4% of patients after noon vs. 3.7% of patients before noon, p = 0.79), estimated blood loss (median 100 cc vs. 100 cc, p = 0.75), blood transfusion rates (7.4% vs. 8.2%, p = 0.85), and conversion to laparotomy (12.6% vs. 7.4%, p = 0.10). There was no difference in operative times between the two groups (198 min vs. 216.5 min, p = 0.10). There was no association between operative start time and postoperative non-infectious complications (11.9% vs. 11.0%, p = 0.87), or postoperative infections (17.8% vs. 12.3%, p = 0.78). Length of hospital stay was longer for surgeries starting after noon (median 2 days vs. 1 day, p = 0.005). No differences were observed in rates of cancer recurrence (12.6% vs. 8.8%, p = 0.39), recurrence-free survival (p = 0.97), or overall survival (p = 0.94). Conclusion Our results indicate equivalent surgical outcomes and no increased risk of postoperative complications regardless of operative start time in minimally invasive endometrial cancer staging, despite longer length of hospital stay for surgeries beginning after noon.
KW - Endometrial cancer
KW - Laparoscopy
KW - Start time
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U2 - 10.1016/j.ygyno.2014.06.007
DO - 10.1016/j.ygyno.2014.06.007
M3 - Article
C2 - 24945591
AN - SCOPUS:84905573265
SN - 0090-8258
VL - 134
SP - 248
EP - 252
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -