Lymphovascular space invasion in robotic surgery for endometrial cancer

Mark R. Hopkins, Abby M. Richmond, Georgina Cheng, Susan Davidson, Monique A. Spillman, Jeanelle Sheeder, Miriam D. Post, Saketh R. Guntupalli

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Minimally invasive surgery has become a standard treatment for endometrial cancer and offers significant benefits over abdominal approaches. There are discrepant data regarding lymphovascular space invasion (LVSI) and positive peritoneal cytology with the use of a uterine manipulator, with previous smallscale studies demonstrating an increased incidence of these prognostically important events. We sought to determine if there was a higher incidence of LVSI in patients who underwent robot-assisted surgery for endometrial cancer. Methods: We performed a single-institution review of medical records for patients who underwent open abdominal or robot-assisted hysterectomy for endometrial cancer over a 24-month period. The following data were abstracted: age, tumor grade and stage, size, depth of invasion, LVSI, and peritoneal cytology. For patients with LVSI, slides were reviewed by 2 pathologists for confirmation of LVSI. Results: Of 104 patients identified, LVSI was reported in 39 (37.5%) and positive peritoneal cytology in 6 (4.8%). Rates of peritoneal cytology were not significantly different between the 2 groups (odds ratio, 0.55; 95% confidence interval, 0.10–3.17; P =.50). LVSI was reported in significantly fewer robot-assisted hysterectomies than open procedures (odds ratio, 0.39; 95% confidence interval, 0.17–0.92; P =.03). In subgroup analyses restricted to early-stage disease (stage ≤ II), there was no significant difference in LVSI between open and robot-assisted hysterectomies (odds ratio, 0.64; 95% confidence interval, 0.22–1.85; P =.43). Conclusion: In this retrospective study, we found that use of a uterine manipulator in robot-assisted surgery did not increase the incidence of LVSI.

Original languageEnglish (US)
Article numbere2014.00021
JournalJournal of the Society of Laparoendoscopic Surgeons
Issue number3
StatePublished - 2014
Externally publishedYes


  • Cytology
  • Endometrial cancer
  • Lymphovascular space invasion
  • Robotic hysterectomy
  • Total abdominal hysterectomy

ASJC Scopus subject areas

  • Surgery


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