J Gynecol Oncol.  2025 Jan;36(1):e13. 10.3802/jgo.2025.36.e13.

Cancer-field surgery for endometrial cancer by robotic peritoneal mesometrial resection and targeted compartmental lymphadenectomy (PMMR+TCL)

• Buderath P
• Dang TM
• Kimmig R

• KMID: 2565441
• DOI: http://doi.org/10.3802/jgo.2025.36.e13

Abstract

Objective
Cancer-field surgery by peritoneal mesometrial resection and targeted compartmental lymphadenectomy (PMMR+TCL) for the treatment of endometrial cancer (EC) aims at optimal locoregional tumor control without the need for adjuvant radiotherapy. In a previous publication we could demonstrate the feasibility of the method and presented encouraging first oncologic data.
Methods
Following up our 2021 publication, we present data on the treatment of EC by PMMR+TCL in much larger cohort and with longer follow-up.
Results
One hundred and thirty-five patients with EC International Federation of Gynecology and Obstetrics (FIGO) I–IV (75.6% FIGO I) underwent cancer field surgery via PMMR+TCL for EC in the years 2016–2023. Mean follow-up in our cohort was 27.5 months (0, 83; 19.7). The procedure was feasible and safe with favorable intra-and postoperative complication rates. Even though 50.4% of patients had an indication for postoperative radiotherapy following national and international guidelines, the rate of postoperative irradiation administered was 10.4%. The overall recurrence rate was 8.1% and we observed 2 (1.5%) isolated locoregional recurrences.
Conclusion
Our results confirm the feasibility and safety of PMMR+TCL in EC patients. Oncologic data are very encouraging and hint at a superior locoregional control without adjuvant irradiation. Larger studies with longer follow-up will be needed to confirm these results.

Keyword

Endometrial Cancer; Cancer-Field Surgery; PMMR; Gynecologic Oncology, Sentinel Lymph Node Biopsy; Robot Surgery