1.Robotic single site versus robotic multiport hysterectomy in early endometrial cancer: a case control study.
Giacomo CORRADO ; Giuseppe CUTILLO ; Emanuela MANCINI ; Ermelinda BAIOCCO ; Lodovico PATRIZI ; Maria SALTARI ; Anna DI LUCA SIDOZZI ; Isabella SPERDUTI ; Giulia POMATI ; Enrico VIZZA
Journal of Gynecologic Oncology 2016;27(4):e39-
OBJECTIVE: To compare surgical outcomes and cost of robotic single-site hysterectomy (RSSH) versus robotic multiport hysterectomy (RMPH) in early stage endometrial cancer. METHODS: This is a retrospective case-control study, comparing perioperative outcomes and costs of RSSH and RMPH in early stage endometrial cancer patients. RSSH were matched 1:2 according to age, body mass index, comorbidity, the International Federation of Gynecology and Obstetric (FIGO) stage, type of radical surgery, histologic type, and grading. Mean hospital cost per discharge was calculated summarizing the cost of daily hospital room charges, operating room, cost of supplies and length of hospital stay. RESULTS: A total of 23 women who underwent RSSH were matched with 46 historic controls treated by RMPH in the same institute, with the same surgical team. No significant differences were found in terms of age, histologic type, stage, and grading. Operative time was similar: 102.5 minutes in RMPH and 110 in RSSH (p=0.889). Blood loss was lower in RSSH than in RMPH (respectively, 50 mL vs. 100 mL, p=0.001). Hospital stay was 3 days in RMPH and 2 days in RSSH (p=0.001). No intraoperative complications occurred in both groups. Early postoperative complications were 2.2% in RMPH and 4.3% in RSSH. Overall cost was higher in RMPH than in RSSH (respectively, $7,772.15 vs. $5,181.06). CONCLUSION: Our retrospective study suggests the safety and feasibility of RSSH for staging early endometrial cancer without major differences from the RMPH in terms of surgical outcomes, but with lower hospital costs. Certainly, further studies are eagerly warranted to confirm our findings.
Adult
;
Aged
;
Aged, 80 and over
;
Case-Control Studies
;
Endometrial Neoplasms/economics/*surgery
;
Female
;
Health Care Costs
;
Humans
;
Hysterectomy/adverse effects/*methods
;
Middle Aged
;
Postoperative Complications/epidemiology
;
Retrospective Studies
;
Robotic Surgical Procedures/adverse effects/economics/*methods
2.Robotic single site versus robotic multiport hysterectomy in early endometrial cancer: a case control study.
Giacomo CORRADO ; Giuseppe CUTILLO ; Emanuela MANCINI ; Ermelinda BAIOCCO ; Lodovico PATRIZI ; Maria SALTARI ; Anna DI LUCA SIDOZZI ; Isabella SPERDUTI ; Giulia POMATI ; Enrico VIZZA
Journal of Gynecologic Oncology 2016;27(4):e39-
OBJECTIVE: To compare surgical outcomes and cost of robotic single-site hysterectomy (RSSH) versus robotic multiport hysterectomy (RMPH) in early stage endometrial cancer. METHODS: This is a retrospective case-control study, comparing perioperative outcomes and costs of RSSH and RMPH in early stage endometrial cancer patients. RSSH were matched 1:2 according to age, body mass index, comorbidity, the International Federation of Gynecology and Obstetric (FIGO) stage, type of radical surgery, histologic type, and grading. Mean hospital cost per discharge was calculated summarizing the cost of daily hospital room charges, operating room, cost of supplies and length of hospital stay. RESULTS: A total of 23 women who underwent RSSH were matched with 46 historic controls treated by RMPH in the same institute, with the same surgical team. No significant differences were found in terms of age, histologic type, stage, and grading. Operative time was similar: 102.5 minutes in RMPH and 110 in RSSH (p=0.889). Blood loss was lower in RSSH than in RMPH (respectively, 50 mL vs. 100 mL, p=0.001). Hospital stay was 3 days in RMPH and 2 days in RSSH (p=0.001). No intraoperative complications occurred in both groups. Early postoperative complications were 2.2% in RMPH and 4.3% in RSSH. Overall cost was higher in RMPH than in RSSH (respectively, $7,772.15 vs. $5,181.06). CONCLUSION: Our retrospective study suggests the safety and feasibility of RSSH for staging early endometrial cancer without major differences from the RMPH in terms of surgical outcomes, but with lower hospital costs. Certainly, further studies are eagerly warranted to confirm our findings.
Adult
;
Aged
;
Aged, 80 and over
;
Case-Control Studies
;
Endometrial Neoplasms/economics/*surgery
;
Female
;
Health Care Costs
;
Humans
;
Hysterectomy/adverse effects/*methods
;
Middle Aged
;
Postoperative Complications/epidemiology
;
Retrospective Studies
;
Robotic Surgical Procedures/adverse effects/economics/*methods
3.Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study.
Stefano UCCELLA ; Francesca FALCONE ; Stefano GREGGI ; Francesco FANFANI ; Pierandrea DE IACO ; Giacomo CORRADO ; Marcello CECCARONI ; Vincenzo Dario MANDATO ; Stefano BOGLIOLO ; Jvan CASARIN ; Giorgia MONTEROSSI ; Ciro PINELLI ; Giorgia MANGILI ; Gennaro CORMIO ; Giovanni ROVIGLIONE ; Alice BERGAMINI ; Anna PESCI ; Luigi FRIGERIO ; Silvia UCCELLA ; Enrico VIZZA ; Giovanni SCAMBIA ; Fabio GHEZZI
Journal of Gynecologic Oncology 2018;29(6):e100-
OBJECTIVE: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. METHODS: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. RESULTS: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2–3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24–6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02–3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13–6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). CONCLUSION: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.
Disease-Free Survival
;
Endometrial Neoplasms*
;
European Union
;
Female
;
Gynecology
;
Humans
;
Lymph Node Excision
;
Lymph Nodes
;
Mortality
;
Obstetrics
;
Prognosis
;
Recurrence
;
Referral and Consultation
;
Retrospective Studies
4.Impact of COVID-19 in gynecologic oncology: a Nationwide Italian Survey of the SIGO and MITO groups
Giorgio BOGANI ; Giovanni APOLONE ; Antonino DITTO ; Giovanni SCAMBIA ; Pierluigi Benedetti PANICI ; Roberto ANGIOLI ; Sandro PIGNATA ; Stefano GREGGI ; Paolo SCOLLO ; Mezzanzanica DELIA ; Massimo FRANCHI ; Fabio MARTINELLI ; Mauro SIGNORELLI ; Salvatore LOPEZ ; Violante Di DONATO ; Giorgio VALABREGA ; Gabriella FERRANDINA ; Innocenza PALAIA ; Alice BERGAMINI ; Luca BOCCIOLONE ; Antonella SAVARESE ; Fabio GHEZZI ; Jvan CASARIN ; Ciro PINELLI ; Vito TROJANO ; Vito CHIANTERA ; Giorgio GIORDA ; Francesco SOPRACORDEVOLE ; Mario MALZONI ; Giovanna SALERNO ; Enrico SARTORI ; Antonia TESTA ; Gianfranco ZANNONI ; Fulvio ZULLO ; Enrico VIZZA ; Giuseppe TROJANO ; Antonio CHIANTERA ; Francesco RASPAGLIESI
Journal of Gynecologic Oncology 2020;31(6):e92-
Objective:
Coronavirus disease 2019 (COVID-19) has caused rapid and drastic changes in cancer management. The Italian Society of Gynecology and Obstetrics (SIGO), and the Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies (MITO) promoted a national survey aiming to evaluate the impact of COVID-19 on clinical activity of gynecologist oncologists and to assess the implementation of containment measures against COVID-19 diffusion.
Methods:
The survey consisted of a self-administered, anonymous, online questionnaire. Thesurvey was sent via email to all the members of the SIGO, and MITO groups on April 7, 2020, and was closed on April 20, 2020.
Results:
Overall, 604 participants completed the questionnaire with a response-rate of 70%. The results of this survey suggest that gynecologic oncology units had set a proactive approach to COVID-19 outbreak. Triage methods were adopted in order to minimize in-hospital diffusion of COVID-19. Only 38% of gynecologic surgeons were concerned about COVID-19 outbreak. Although 73% of the participants stated that COVID-19 has not significantly modified their everyday practice, 21% declared a decrease of the use of laparoscopy in favor of open surgery (19%). However, less than 50% of surgeons adopted specific protection against COVID-19. Additionally, responders suggested to delay cancer treatment (10%–15%), and to perform less radical surgical procedures (20%–25%) during COVID-19 pandemic.
Conclusions
National guidelines should be implemented to further promote the safety of patients and health care providers. International cooperation is of paramount importance, as heavily affected nations can serve as an example to find out ways to safely preserve clinical activity during the COVID-19 outbreak.