ArticleBMJ open2021
Economic evaluation of different routes of surgery for the management of endometrial cancer: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- Laparoscopic versus robotic surgery in the setting of combined resection of colorectal cancer and liver metastases: an experience from the I Go MILS registry.Updates in surgery · 2026Article
- Sentinel lymph node and operative outcomes in patients with endometrial cancer and a BMI ≥ 50: the SLOPE-50 study.Journal of robotic surgery · 2026Article
- Endo-cost: efficient economic model of adopting robotic versus laparoscopic gynecological surgery for endometrial cancer.Journal of robotic surgery · 2025Article
- Impact of obesity on the outcomes and cost of robotic surgery for Stage IA endometrial cancer: a regional perspective from Japan.International journal of clinical oncology · 2025Article
- Article
- Treatment of endometrial cancer from 2000 to 2020 in Germany: a retrospective population based cohort study.Journal of cancer research and clinical oncology · 2024Article
- Regional variations and deprivation are linked to poorer access to laparoscopic and robotic colorectal surgery: a national study in England.Techniques in coloproctology · 2023Article
- Observational
- Is robotic lobectomy cheaper? A micro-cost analysis.Journal of robotic surgery · 2022Article
- Should Endometrial Cancer Treatment Be Centralized?Biology · 2022Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe benefits of minimally invasive surgery (MIS) for endometrial carcinoma (EC) are well established although the financial impact of robotic-assisted hysterectomy (RH) compared with laparoscopic hysterectomy (LH) is disputed.
designRetrospective cohort study.
settingEnglish National Health Service hospitals 2011-2017/2018.
participants35 304 women having a hysterectomy for EC identified from Hospital Episode Statistics. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the association between route of surgery on cost at intervention, 30, 90 and 365 days for women undergoing an open hysterectomy (OH) or MIS (LH/RH) for EC in England. The average marginal effect was calculated to compare RH versus OH and RH versus LH which adjusted for any differences in the characteristics of the surgical approaches. Secondary outcomes were to analyse costing data for each surgical approach by age, Charlson Comorbidity Index (CCI) and hospital MIS rate classification.
resultsA total of 35 304 procedures were performed, 20 405 (57.8%) were MIS (LH: 18 604 and RH: 1801), 14 291 (40.5%) OH. Mean cost for LH was significantly less than RH, whereas RH was significantly less than OH at intervention, 30, 90 and 365 days (p<0.001). Over time, patients who underwent RH had increasing CCI scores and by the 2015/2016 year had a higher average CCI than LH. Comparing the cost of LH and RH against CCI score identified that the costs closely reflected the patients' CCI. Increasing disparity was also seen between the MIS and OH costs with rising age. When exploring the association between provider volume, MIS rate and surgical costs, there was an association with the higher the MIS rate the lower the average cost.
conclusionsFurther research is needed to investigate costs in matched patient cohorts to determine the optimum surgical modality in different populations.
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