Trend and characteristics of minimally invasive surgery for patients with endometrial cancer in Japan - PubMed (original) (raw)
Observational Study
Trend and characteristics of minimally invasive surgery for patients with endometrial cancer in Japan
Hiroshi Yoshida et al. J Gynecol Oncol. 2023 May.
Abstract
Objective: Owing to the potential benefits of minimally invasive hysterectomy for endometrial cancer, the practice pattern has recently shifted in Japan. This study examined the trends in minimally invasive surgery (MIS) in patients with endometrial cancer in Japan.
Methods: This retrospective observational study examined the Japan Society of Obstetrics and Gynecology Tumor Registry database between 2015-2019. This study examined the time-specific proportion change and predictors of MIS use in initial endometrial cancer treatment in Japan, and compared it with the use of abdominal surgery. Additionally, the association between hospital surgical treatment volume and MIS use was examined.
Results: A total of 14,059 patients (26.5%) underwent minimally invasive hysterectomy, and 39,070 patients (73.5%) underwent abdominal hysterectomy in the study period. Patients who underwent MIS were more likely to be treated at high-volume centers, younger, central, or western Japan residents, registered in recent years, and had a tumor with stage I disease, type 1 histology, and less myometrial invasion (all adjusted p<0.05). The proportion of MIS treatments increased from 19.1% in 2015 to 34.3% in 2019 (p<0.001). On multivariable analysis, treatment at high-volume centers was a contributing factor for MIS (adjusted odds ratio=3.85; 95% confidence interval=3.44-4.30). MIS at high-volume centers increased significantly from 24.8% to 41.0% (p<0.001) during the study period, whereas MIS at low-volume centers remained at median 8.8%.
Conclusion: MIS has increased significantly in recent years, accounting for nearly 34% of surgical management of endometrial cancer in Japan. High-volume treatment centers take the lead in performing MIS.
Keywords: Endometrial Cancer; High-Volume; Hospitals; Minimally Invasive Surgery; Tendency.
© 2023. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.
Conflict of interest statement
No potential conflict of interest relevant to this article was reported.
Figures
Fig. 1. Selection criteria.
JSOG, Japan Society of Obstetrics and Gynecology.
Fig. 2. Temporal trends of MIS in endometrial cancer. Surgical types (MIS and abdominal surgery) of endometrial cancer are shown. Lines are modeled estimates and points represent the actual data.
MIS, minimally invasive surgery.
Fig. 3. Distribution of annualized surgical volume and MIS cases. The annual surgical cases of each hospital among MIS cases and all cases of endometrial cancer are shown. Dotted lines are modeled estimates and bars represent actual data.
MIS, minimally invasive surgery.
Fig. 4. Proportion of MIS based on hospital treatment volume. Hospital types (high-, moderate-, and low-treatment-volume centers) and the proportion of MIS for endometrial cancer are shown. Lines are modeled estimates and points represent the actual data.
MIS, minimally invasive surgery.
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