Patient-reported outcomes and experiences following robotic, laparoscopic, and open surgery for endometrial cancer

Endometrial cancer is the most common gynecologic malignancy in developed countries, and minimally invasive surgery is increasingly used. However, comparisons among surgical approaches regarding patient-centered outcomes remain scarce. In this study, we aimed to compare patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) between minimally invasive (robotic and laparoscopic) and open surgeries for endometrial cancer staging, and to assess functional, physical, and emotional domains.

This cross-sectional study was conducted at Barretos Cancer Hospital (Brazil) with retrospective clinical data and prospective collection of PROMs and PREMs. A total of 182 women with histologically confirmed endometrial cancer underwent robotic (n = 29), laparoscopic (n = 91), or open surgery (n = 62) between January 2020 and December 2023. Statistical analyses were descriptive and univariate to explore associations between surgical approach and outcomes.

Overall, PROMs were highest in the robotic group (72.2 ± 6.6), followed by laparoscopic (70.8 ± 6.4) and open (70.2 ± 7.4). PREMs showed a similar pattern-robotic (98.8 ± 4.1), open (97.5 ± 3.9), and laparoscopic (97.0 ± 6.1). Robotic surgery achieved higher satisfaction (99.7 ± 7.2), sexual function (78.1 ± 23.9), and quality of life (86.6 ± 12.6). Laparoscopy favored mobility (88.6 ± 18.8) and daily activities (89.4 ± 21.7), while open surgery had higher emotional wellbeing (80.8 ± 21.6) but more gastrointestinal symptoms.

Robotic surgery yielded better satisfaction, quality of life, and sexual function; laparoscopy improved mobility and daily activities; and open surgery enhanced emotional wellbeing. PROMs and PREMs proved feasible for evaluating patient-centered outcomes and revealed meaningful differences supporting personalized surgical decisions.