ArticleWorld journal of surgical oncology2025
'En bloc' peritoneal mesometrial resection (PMMR) and pelvic targeted compartmental lymphadenectomy (TCL) for management of patients with endometrial cancer - feasibility and safety study of a 'new kid on the block' in robotic surgery.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRobotic Peritoneal Mesometrial Resection and Targeted Compartmental Lymphadenectomy (PMMR + TCL) is a procedure following Cancer Field Surgery concept for endometrial cancer (EC), enabling superior locoregional control without adjuvant irradiation. We aimed to test the feasibility and safety of performing the PMMR + TCL by a newly trained team in a robotic approach.
methodsA single-institution, retrospective analysis of patients undergoing robotic surgery (DaVinci) for EC was performed. The PMMR + TCL was compared to a robotic simple hysterectomy (rSH) and sentinel lymph node dissection (SLND). The primary outcomes were the rate of PMMR + TCL among all robotic surgeries and the 30-day complications (Clavien-Dindo classification).
resultsThe PMMR + TCL was performed on 79 (66.9%), rSH + SLND with afferent lymphatic vessels on 17 (14.4%), rSH + SLND alone on 20 (16.9%), and radical hysterectomy with SLND/lymphadenectomy on 2 (1.6%) patients, with the median number (range) of removed lymph nodes of 8 (2-12), 6 (2-10), 6 (1-7), and 26 (4-26), respectively. Patients in whom the PMMR + TCL was performed were younger, had lower BMI, and fewer co-morbidities as compared to those who underwent other procedures. Thirteen (11%) patients experienced complications, with 3 (2.5%) grade IIIb, of which none could be directly linked to any type of procedure. Ten (8.5%) patients experienced postoperative grade I-II complications, which tended to be more frequent after PMMT + TCL. Endometriosis and carcinoma deposits were found between uterus and lymph nodes in 7 (8.8%) of PMMR + TCL specimens.
conclusionsPerforming PMMT + TCL by a team newly trained in robotic surgery was feasible and relatively safe. Further research on locoregional control after PMMR + TLC without adjuvant irradiation should be conducted.
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