Endometrial cancer is the most common gynecologic cancer in the US, and most patients are diagnosed with early-stage disease. Surgery is often curative and the sole modality of treatment in this group of patients [1,2]. Over the last 20 years, the surgical treatment of endometrial cancer has shifted, partly due to the publication of the Gynecologic Oncology Group (GOG)-LAP2 trial in 2009 [3,4]. In this randomized study, laparoscopy improved perioperative outcomes in patients with endometrial cancer without compromising oncologic outcomes [3,4]. The Laparoscopic Approach to Cancer of the Endometrium (LACE) trial also demonstrated equivalent oncologic outcomes among patients who underwent laparoscopy versus laparotomy for clinically early-stage endometrial cancer [5]. These studies led to widespread adoption of minimally invasive surgery (MIS) techniques, including robot-assisted (RA) MIS, as the preferred surgical approach for the treatment of endometrial cancer [6,7].

RA laparoscopy offers several important benefits, including a 3-dimensional view, fatigue-resistant robotic arms, and wristed movement, which enhances the dexterity of instruments [6,7]. Disadvantages of RA MIS include increased acquisition and maintenance costs and loss of tactile sensation and feedback [8]. Despite these limitations, Argenta et al. recently published their results of a single-institution retrospective analysis of RA versus laparoscopic MIS for the treatment of stage 1 endometrial cancer. The authors concluded that RA MIS was associated with poorer recurrence-free survival (HR: 1.41, 95% CI: 1.12–1.77) and overall survival (OS; HR: 1.39, 95% CI: 1.06–1.83) [9].

We sought to investigate differences in progression-free survival (PFS), disease-specific survival (DSS), and OS in patients with clinically early-stage endometrioid endometrial adenocarcinoma grossly confined to the uterus who underwent RA laparoscopy versus conventional laparoscopy.