The current evidence for the use of minimally-invasive surgery in endometrial cancer

Abstract

The aim of the present study is to review the current available data regarding the use of minimally-invasive surgery in endometrial cancer patients and investigate the feasibility and safety of it for cancer control. We also reviewed the current understanding of sentinel lymph node mapping and the use of robotic surgery in endometrial cancer. Studies have consistently demonstrated better short-term outcomes of minimally-invasive surgery in endometrial cancer compared to laparotomy such as less blood loss, shorter hospital stay, and fewer wound complications. Large randomized clinical trials and meta-analyses also suggest the feasibility and safety of minimally-invasive surgery in terms of oncologic outcomes especially in patients with early stage disease. Although evidence for advanced stage disease and patients with high risk for recurrence are still lacking, the current available data seem to support the use of minimally-invasive surgery for those patient groups as well. A large body of literature supports the role of sentinel lymph node mapping in endometrial cancer with a high sensitivity and a low false negative rate, as well as a favorable negative predictive value. Studies also show that robotic surgery is a safe and effective alternative to conventional laparoscopic surgery for endometrial cancer staging but further long-term data are required. Further prospective studies with long-term follow-up are warranted to evaluate the feasibility and safety of minimally-invasive surgery especially in patients with advanced stage disease and high risk for recurrence. However, the current available data support the use of minimally-invasive surgery in all patient groups of endometrial cancer.