Survival Impact of Robotic-Assisted Laparoscopy (RAL) vs. Conventional Laparoscopy (LPS) in the Treatment of Endometrial Cancer

Abstract

Objective: This study aimed to assess the impact of minimally invasive surgery (MIS) on survival rates in women diagnosed with endometrial cancer (EC). Methods: A retrospective cohort of 723 women who underwent MIS for EC was analyzed, with 468 having conventional laparoscopy (LPS) and 255 undergoing robotic-assisted laparoscopy (RAL). Sociodemographic features, tumor characteristics, and survival rates were examined for the entire cohort and in a propensity score-matched model. Results: In the overall sample, women who underwent RAL were older, had higher BMI, more comorbidities, and more aggressive tumors. After matching for age, BMI, comorbidities, ASA score, histological type, grade, myometrial invasion, LVSI, and FIGO stage, 482 patients (241 matched pairs) were selected. Disease-free survival (DFS) HR: 1, overall survival (OS) HR: 0.9, and specific survival related to EC (SS) HR: 0.15 were similar between the LPS and RAL groups. Conclusions: These findings suggest that the choice of surgical approach (robotic or laparoscopic) does not impact survival outcomes when matched in homogeneous groups.